Perspective | Published:

Cannabis shenanigans: advocating for the restoration of an effective treatment of pain following spinal cord injury

Spinal Cord Series and Casesvolume 4, Article number: 67 (2018) | Download Citation


Cannabis is an effective treatment for pain following spinal cord injury that should be available to patients and researchers. The major argument against the rescheduling of cannabis is that the published research is not convincing. This argument is disingenuous at best, given that the evidence has been presented and rejected at many points during the political dialog. Moreover, the original decision to criminalize cannabis did not utilize scientific or medical data. There is tension between the needs of a society to protect the vulnerable by restricting the rights of others to live well and with less pain. It is clear that this 70-year war on cannabis has had little effect in controlling the supply of cannabis. Prohibition can never succeed; “it is a tyranny from which every independent mind revolts.” People living with chronic pain should not have to risk addiction, social stigma, restrictions on employment and even criminal prosecution in order to deal with their pain. It is time to end the shenanigans and have an open, transparent discussion of the true benefits of this much-beleaguered medicine.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. 1.

    National Academies of Sciences E, Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington, DC: The National Academies Press; 2017.

  2. 2.

    Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015;313:2456–73.

  3. 3.

    Baron EP. Comprehensive review of medicinal marijuana, cannabinoids, and therapeutic implications in medicine and headache: what a long strange trip it’s been. Headache. 2015;55:885–916.

  4. 4.

    The International Opium Commision. BMJ 1910;1:93–7.

  5. 5.

    Bonnie RJ, Whitebread CH. The forbidden fruit and the tree of knowledge: an inquiry into the legal history of American marijuana prohibition. Va Law Rev. 1970;56:971–1203.

  6. 6.

    New York Academy of Medicine. The La Guardia Committee Report: The Marihuana Problem in the City of New York. Mayor's Committee on Marihuana, by the New York Academy of Medicine. City of New York: New York Academy of Medicine; 1944.

  7. 7.

    Gasner L. Refer madness. 1938.

  8. 8.

    Anslinger HJ, Cooper, CR. Marijuana, assassin of youth. The American Magazine. New York, 1937.

  9. 9.

    Bromberg W. Marihuana: a psychitric study. JAMA. 1939;113:1–12.

  10. 10.

    Gray M. Drug crazy:how we got into this mess and how we get out. New York: Routledge; 2000.

  11. 11.

    Andreae MH, Rhodes E, Bourgoise T, Carter GM, White RS, Indyk D, et al. An ethical exploration of barriers to research on controlled drugs. Am J Bioeth. 2016;16:36–47.

  12. 12.

    Medicine NYAo. The La Guardia Committee Report: the marihuana problem in the city of New York. Mayor’s Committee on Marihuana, by the New York Academy of Medicine. City of New York: New York Academy of Medicine; 1944.

  13. 13.

    Long TW, M Demske D, Leipe C, Tarasov P. Cannabis in Eurasia: origin of human use and bronze age trans-continental connections. Veg Hist Archaeobotany. 2017;26:245–58.

  14. 14.

    Brand E, Zhao z. Cannabis in Chinese medicine: are some traditional indications referenced in ancient literature related to cannabinoids? Front Pharmacol. 2017;8:1–11.

  15. 15.

    Earleywine M. Understanding marijuana. New York: Oxford Univ. Press; 2002.

  16. 16.

    O’Shaughnessy WB. New remedy for tetanus and other convulsive disorders. Boston Med Surg J. 1840;23:153–5.

  17. 17.

    Birch E. The use of Indian hemp in the treatment of chronic chloral and chronic opium poisoning. Lancet. 1889;133:625.

  18. 18.

    B. Prohibition. Science. 1887;IX:105-6.

  19. 19.

    Medicine Io. Marijuana as medicine? The science beyond the controversy. Washington, DC: The National Academies Press; 2000.

  20. 20.

    ACLU. The war on Marijuana in Black and White. New York, NY: ACLU; 2013.

  21. 21.

    Cooper HLF. War on drugs policing and police brutality. Subst Use Misuse. 2015;50:1188–94.

  22. 22.

    Bauman WA, La Fountaine MF, Cirnigliaro CM, Kirshblum SC, Spungen AM. Administration of increasing doses of gonadotropin-releasing hormone in men with spinal cord injury to investigate dysfunction of the hypothalamic-pituitary-gonadal axis. Spinal Cord. 2017;56:247–58.

  23. 23.

    United Nations. Single Convention on Narcotic Drugs. Treaty Series, Vol. 1, Chapter VI, Title 15. New York: United Nations; 1961.

  24. 24.

    Devane WA, Dysarz FA 3rd, Johnson MR, Melvin LS, Howlett AC. Determination and characterization of a cannabinoid receptor in rat brain. Mol Pharmacol. 1988;34:605–13.

  25. 25.

    Joy J, Watson SJ, BEnson JA. Marijuana and medicine: assessing the science base. Washington, DC: National Academy Press; 1999.

  26. 26.

    Jensen MP, Hoffman AJ, Cardenas DD. Chronic pain in individuals with spinal cord injury: a survey and longitudinal study. Spinal Cord. 2005;43:704–12.

  27. 27.

    Cardenas DD, Jensen MP. Treatments for chronic pain in persons with spinal cord injury: a survey study. J Spinal Cord Med. 2006;29:109–17.

  28. 28.

    Atkins AM, Gonzalez F, Joyo B, Aisen ML, Atkins AM, Gonzalez F, et al. Tapering opioid prescriptions and reducing polypharmacy for inpatients with spinal cord injury at Rancho Los Amigos National Rehabilitation Center. J Rehabil Res Dev. 2014;51:vii–xiv.

  29. 29.

    Siddall PJ, Loeser JD. Pain following spinal cord injury. Spinal Cord. 2001;39:63–73.

  30. 30.

    Siddall PJ, McClelland JM, Rutkowski SB, Cousins MJ. A longitudinal study of the prevalence and characteristics of pain in the first 5 years following spinal cord injury. Pain. 2003;103:249–57.

  31. 31.

    Putzke JD, Williams MA, Daniel FJ, Bourge RC, Boll TJ. Activities of daily living among heart transplant candidates: neuropsychological and cardiac function predictors. J Heart lung Transplant. 2000;19:995–1006.

  32. 32.

    Turner JT, Lee V, Fletcher K, Hudson K, Barton D. Measuring quality of care with an inpatient elderly population. The geriatric resource nurse model. J Gerontol Nurs. 2001;27:8–18.

  33. 33.

    Ville I, Ravaud JF. Subjective well-being and severe motor impairments: the Tetrafigap survey on the long-term outcome of tetraplegic spinal cord injured persons. Soc Sci Med. 1982;52:369–84. 2001

  34. 34.

    Putzke JD, Richards JS, Kezar L, Hicken BL, Ness TJ. Long-term use of gabapentin for treatment of pain after traumatic spinal cord injury. Clin J Pain. 2002;18:116–21.

  35. 35.

    MTJR Nobel, Treagear SJ, Coates VH, Wiffen PJ, Akafomo C, Schoelles KM. Long-term opioid management for chronic noncancer pain. Cochrane Database Syst Rev. 2010;1:CD006605.

  36. 36.

    Parker-Pope. Times Health. New York Times. 2 May 2013.

  37. 37.

    Reiman A, Welty M, Solomon P. Cannabis as a substitute for opioid-based pain medication: patient self-report. Cannabis Cannabinoid Res. 2017;2:160–6.

  38. 38.

    Heutink M, Post MW, Wollaars MM, van Asbeck FW. Chronic spinal cord injury pain: pharmacological and non-pharmacological treatments and treatment effectiveness. Disabil Rehabil. 2011;33:433–40.

  39. 39.

    Meng H, Johnston B, Englesakis M, Moulin DE, Bhatia A. Selective cannabinoids for chronic neuropathic pain: a systematic review and meta-analysis. Anesth Analg. 2017;12:1638–52.

  40. 40.

    Wilsey B, Marcotte TD, Deutsch R, Zhao H, Prasad H, Phan A. An exploratory human laboratory experiment evaluating vaporized cannabis in the treatment of neuropathic pain from spinal cord injury and disease. J Pain. 2016;17:982–1000.

  41. 41.

    Wilsey BL, Deutsch R, Samara E, Marcotte TD, Barnes AJ, Huestis MA, et al. A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis. J Pain Res. 2016;9:587–98.

  42. 42.

    Piper BJ, DeKeuster RM, Beals ML, Cobb CM, Burchman CA, Perkinson L, et al. Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep. J Psychopharmacol (Oxf, Engl). 2017;31:569–75.

  43. 43.

    Schmidt LA, Jacobs LM, Spetz J. Schmidt et al. Respond. Am J Public Health. 2016;106:e8–e9.

  44. 44.

    Ware MA, Wang T, Shapiro S, Collet JP. Cannabis for the management of pain: assessment of safety study (COMPASS). J Pain. 2015;16:1233–42.

  45. 45.

    Cook J, Lloyd-Jones DM, Ogden E, Bonomo Y. Medical use of cannabis: an addiction medicine perspective. Intern Med J. 2015;45:677–80.

  46. 46.

    Hilts P. Is nicotine addictive? It depends on whose criteria you use. New York Times. 2 August 1994;C 3.

  47. 47.

    Nutt DJKLAN DE. Effects of schedule I drug laws on neuroscience research and treatment innovation. Neuroscience. 2013;14:577–85.

  48. 48.

    Cohen PJ. Medical marijuana 2010: it’s time to fix the regulatory vacuum. J Law Med Ethics. 2010;38:654–66.

  49. 49.

    Clark PA. The ethics of medical marijuana: government restrictions vs. medical necessity. J Public Health Policy. 2000;21:40–60.

  50. 50.

    Bone M, Seddon T. Human rights, public health and medicinal cannabis use. Crit Public Health. 2016;26:51–61.

Download references

Author information


  1. Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA, USA

    • Daniel E. Graves


  1. Search for Daniel E. Graves in:

Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Daniel E. Graves.

About this article

Publication history






Further reading