JAMA Case Report: 10 years of suffering with a severe skin condition relieved in 10 minutes by medical cannabis

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Imagine that for every day of your life for the last 10 years you’ve been plagued by severely itchy skin over your entire body. You scratch, you bleed, you scar; you try every medication there is and nothing works. Your skin has become unsightly, you withdraw, you become depressed – you’re ready to go off the deep end. Then one day your doctor says put this oil under your tongue and see what happens. And 10 minutes after you first try it your itching is cut in half and 16 months later it’s disappeared. Sounds like a fairy tale involving a magic potion, except it’s not.

It’s the case history of a woman in her 60s treated at the Johns Hopkins School of Medicine and reported in JAMA a few days ago. The authors describe an untreatable, extremely severe condition called pruritus, (which was coupled with liver disease), that responded immediately to medical cannabis administered just twice a week: she either smoked THC or put a tincture of combination THC and cannabinol (CBN) under her tongue.

The results were stunning:

Within 10 minutes after the initial administration, her Worst Itch Numeric Rating Scale (WI-NRS) score improved from 10 of 10 to 4 of 10. With continued treatment … the score on the WI-NRS … was sustained at the 1-year follow-up, and then to 0 of 10 at the 16-month and 20-month follow-up. Aside from mild sedation, she reported no adverse effects. She was able to stop taking her other anti[itching] medications … She reported an improvement in quality of life, with Dermatology Life Quality Index score reduction from 17 to 7 at 3 months, and then to 1 at 20 months.

They’re not quite sure why it works but suggest 4 mechanisms: that cannabis makes for oily skin, increases the threshold for feeling itchiness (~ pain), decreases nerve conduction of the itch signal, and reduces inflammation. The well known anti-inflammatory property of cannabidiol caused one herbal medicine expert to wonder if adding CBD would make the treatment even more effective:

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