One morning in fall 2018, I collapsed from pain. It felt like I was getting stabbed in my right side, right in the ovary. I dragged myself across the floor to get myself into bed, but I couldn’t. My roommate wanted to know if she should get me some Advil. Advil is not going to fix this, I remember thinking.
So I waited until the pain reduced to a level I could handle and made an appointment at a gynecologist’s office for the next morning.
In her office, we discussed my history with period pain and birth control. She suggested I might have endometriosis. Upon doing an ultrasound, she found an endometrioma, or cyst, on my right ovary, confirming her diagnosis. The pain, she said, and my horrible periods were because of endo.
I immediately asked what we could do about the pain. Apart from hormonal birth control and invasive surgery, she said, pain management options were few and far between. She suggested Epsom salt baths and pelvic floor therapy. I could afford the salt baths, but not the therapy.
She recommended a lot of foods that might reduce inflammation and told me to order a good heating pad. Finally, she asked if I smoked weed. I did.
I’m lucky to live in Washington, D.C., where both medical and recreational marijuana use are legal. In the evenings and on weekends, I can feel some actual relief by using THC as medicine. But I also work a full-time job and can’t — and don’t want to — get high at work.
If I’m having a serious pain flare during the day, I have to “work through it” until I can get home and smoke. Working through the feelings of nausea and the fear of a cyst rupturing usually involves a combination of ibuprofen, acetaminophen, a heating pad, peppermint tea, herbal remedies like cramp bark, and, sometimes, tears.
Being in this much pain, with no absolute solution, is a common problem among chronically ill people for whom THC brings the most relief.
Erin Cotter Cartwright is a 29-year-old woman living with migraine, endometriosis, and a connective tissue disorder. She says vaping THC concentrates has caused a “huge and swift change in [her] daily pain.” While it remains the most effective pain relief, at work, she sticks to over-the-counter (OTC) Excedrin or a low dose of oxycodone.
Cannabis is legal where she lives, in Massachusetts, but Erin still worries about losing access. Without THC, she says, her “mobility would be lessened, [her] diet would probably suffer, and… [her] mood would be severely impacted.”
Leah lives in Seattle and has access to medicinal and recreational cannabis. She uses both CBD and THC to manage her pain caused by Ehlers-Danlos syndrome but worries about how it might affect her job. When pain comes on during a shift, she “just [has] to deal with it.”
If she could, she says, she would step outside to smoke, but “even in a state where recreational and medicinal use is widely accepted, the workplace is still a place where cannabis is considered drugs.”
Leah’s fear illustrates one of the biggest problems with cannabis use, even in states where it’s legal. Cannabis is considered a Schedule I substance and remains illegal federally. This complicates people’s ability to use it — even medicinally — without fear of retribution.
The answer, unfortunately, is that there isn’t a perfect solution yet. And the verdict on whether CBD is as effective for chronic pain is a mixed bag.
Marissa lives in Arkansas, where THC is not very accessible. Even though medical marijuana is legal, she says the initial cost is too high for it to be the right option for her. She found that acupuncture and pelvic floor therapy helped her pain caused by endometriosis, adenomyosis, and interstitial cystitis, but they were also far too expensive to keep up with the frequent appointments required to see results.
For now, Marissa uses heat and CBD to manage her symptoms. “[CBD helps] to an extent,” she says. It enables her to have sex, which she finds is usually too painful.
I’ve not had the same success with CBD. After taking it orally several times, I found no change whatsoever in my pain and have kept using THC whenever possible.
Erin points out that it’s hard to find alternative medicine options because Americans think “it’s either Western medicine or it’s quackery.” To her mind, this limits our ability to “explore alternative avenues that may bring widespread relief.”
She’s right. Doctors fail to listen to patients’ lived experiences, and many patients find their success stories dismissed without any attempt to validate or explore their healing or comfort.
This dismissal, rooted in ableism, accessibility, legality, or stigma, creates additional challenges for chronic pain patients. We deserve to have legal, affordable, and reliable options that mitigate our pain while allowing us to live full lives.
I’m lucky to have a gynecologist who is willing to try every possible solution with me. I use tinctures of motherwort and cramp bark. I take turmeric supplements. She never dismisses these options as quack medicine, and she listens to her other patients with similar conditions and suggests things based on their successes and failures.
Not every alternative pain management solution is going to be the right fit, but especially for conditions where pain management is the only course, doctors should educate themselves on serving their patients, even if it means accepting the limits of Western medicine. At this point, the healthcare industry is already failing us. The least doctors can do is believe our pain and help us find good solutions for it.
Reina Sultan (she/her) is a Lebanese-American Muslim woman working on gender and conflict issues at her nine-to-five. Her work can also be found in Huffington Post, Rewire.News, Wear Your Voice Mag, and Rantt. Follow @SultanReina on Twitter for endless hot takes and photos of her extremely cute cats.