Cannabis Cookies, why and how 

Cannabis cookies can be used in case of pain due to multiple sclerosis, neuropathy or other difficult to treat discorders, such as intractable abdominal pain.

Related to the latter: Treatment resistent abdominal pain, with unknown etiology can sometimes be treated succesfully by Cannabis. It might be that this chronic pain syndrome has something to do with small fiber neuropathy in the innervation network around the gut. But, whatever its etiology, it is merely a hypothesis and very difficult to substantiate.

However, having said that, there are patients suffering from for instance diabetic painful neuropathy, with severe gasterointestinal complaits, and we feel these pains and complaints can be due to small fiber neuropthy.

As Cannabis appeared to be a useful drug for treating treatment resistant neuropathic pain, we sometimes prescribe Cannabis to patients suffering from treatment resistent abdominal pain, and we follow the so called ex juvantibus approach. This means we give the patient the befifit of the doubt, that the pain might be caused by an internal neuropathy, and if so, whether the patients responds favourable on a treatment regime withn Cannabis, orally taken.

Cannabis is easy to combine with other treatment regimes for neuropathic pain, as long as you coach patients in tapering in and in the various ways to use Cannabis.  

Jan  M. Keppel Hesselink, MD, PhD, august 2010