Good Question: What Is 'Intractable Pain'?
MINNEAPOLIS (WCCO) -- By August 2016, people with intractable pain will be considered for Minnesota's medical marijuana program. The Department of Health added that qualifying condition on Wednesday saying it was "the compassionate choice." Intractable pain now joins nine other conditions approved by the Department of Health, including seizures, spasms and certain kinds of cancers.
But, what is intractable pain? Good Question.
"Intractable pain is severe or relenting or present most of the time," said Dr. James Welters, a family medicine doctor with Northwest Family Physicians. "It interferes with daily activities, sleeping, taking care of family, kids, working."
Intractable pain is different from chronic pain, which reportedly affects up to 40 percent of people at some point in their lives. Chronic pain is defined as any kind of pain that goes on for more than three to six months. Intractable pain, on the other hand, can't be cured.
"For a lot of people, it takes over their lives," said Dr. Welters.
The 2014 Minnesota Medical Cannabis Law specifically defines intractable pain as a condition "in which the cause of the pain cannot be removed or otherwise treated with the consent of the patient and in , which, in the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible, or none has been found after reasonable efforts."
Patrick McCllelan is an example of a patient with intractable pain. His rare form of muscular dystrophy leaves him with severe muscles spasms all over his body for more than a decade. He takes 32 pills a day, but that only dulls his pain to a point.
"I think people can relate to a very bad Charley horse in your leg," McClellan said. "Take that pain, multiply times ten different muscles going off."
Doctors says it's hard to measure exactly how many people are affected with intractable pain because it can be caused by so many things, including injuries, car accidents, multiple sclerosis, rheumatoid arthritis, some chronic abdominal conditions or daily migraine headaches. The department of health doesn't have a good sense of how many more people will come to the state's program due to the changes. LeafLine Lab's CEO Manny Munson-Regala says a reasonable estimate garnered from other state's programs would be two to ten times more than every other condition.
Though the definition is specified in the law, the Department of Health said the decision on whether to apply for medical marijuana certification will be left to the patient and his or her doctor.
"It's about the clinician knowing the patient well enough that they know how much pain is impacting that person's life," said Dr. Tom Arneson, research manager of the MN Department of Health's Office of Medical Cannabis.
Dr. Welters' practice is not enrolled in the state's medical cannabis program, but says he would take a number of factors into consideration were a patient to inquire about it. He would review what's already been tried, what the patient is doing now, underlying conditions and any history of chemical dependency, anxiety or depression.
"Ultimately, you have to trust the patient when they describe how much pain they're having," he said.