Cannabis and AiArthritis: What Patients Need to Know
Cannabis use among people living with autoimmune and autoinflammatory arthritis (AiArthritis) has quietly shifted from a fringe conversation to a mainstream reality. Patients are using it for pain, sleep, nausea, anxiety, mood, and quality of life—often long before their doctors feel comfortable discussing it. Five years after AiArthritis last tackled this topic, it was time for an honest update.
In AiArthritis Voices 360 – Episode 115, patient leaders and subject-matter experts came together to unpack what has changed, what hasn’t, and what patients truly need to know before adding cannabis to their care plan .
This conversation wasn’t about hype. It was about lived experience, evolving science, legal reality, and patient safety.
Ep 115: CBD and Cannabis in 2025: Where are We Now?
Cannabis has come a long way since we last covered it in 2020. With more patients using CBD and medical cannabis to help manage chronic pain, inflammation, anxiety, and sleep issues, it is time for an important update. In this episode, AiArthritis Health Education Manager Leila P. L. Valete is joined by co-hosts and patient advocates Eileen Davidson and Bridget Seritt for a real conversation about what has changed, what we still need to learn, and what patients should know before trying cannabis for autoimmune and autoinflammatory arthritis.
From CBD to the Whole Plant: What’s Changed?
In 2020, most conversations centered on CBD alone. Today, patients are increasingly using full-spectrum cannabis, meaning products that contain THC, CBD, and other cannabinoids and terpenes working together (often called the entourage effect).
Patients report benefits that go beyond pain relief, including:
- Improved sleep
- Reduced nausea
- Better mood regulation
- Improved ability to cope with chronic illness
- Enhanced overall quality of life
That said, evidence still leans heavily on patient-reported outcomes, not long-term randomized clinical trials. For many clinicians, that gap remains a major barrier to formal recommendation or prescribing.
Stigma Is Shifting—but Not Evenly
Social stigma around cannabis has decreased dramatically in places like Canada, California, Colorado, and parts of Europe. Government-regulated dispensaries, standardized testing, and clearer labeling have helped normalize its use.
Medical acceptance, however, remains uneven:
- Some clinicians are open to discussion but won’t guide dosing
- Others still avoid the topic entirely
- Reactions vary widely—even within the same healthcare system
Patients often find themselves navigating cannabis alone, despite using it specifically to manage medically complex diseases .
Forms of Cannabis: Not One-Size-Fits-All
Cannabis is not a single product. Different forms behave very differently in the body:
Edibles
- Longer-lasting effects
- Stronger binding in the body
- Higher risk of overdoing it
- Not tolerated well by some patients with GI disease
Inhaled (smoked or vaporized)
- Faster relief
- Shorter duration
- Raises lung-health concerns, especially for patients at risk of interstitial lung disease
Topicals
- Localized pain relief
- Minimal systemic effects
- Often underestimated but surprisingly effective for joint and muscle pain
Each method carries different benefits and risks, and what works one day may not work the next—especially in bodies already affected by immune dysregulation.
Lung Health Matters—Especially in Rheumatic Disease
People with inflammatory arthritis already face increased lung risks. Any inhalation—smoking or vaporizing—introduces potential harm.
Key takeaways:
- Vaporizing flower is generally considered less harmful than smoking, but not risk-free
- Vape cartridges carry their own safety concerns
- Lung involvement in diseases like RA, lupus, and Sjögren’s must be considered
- Inhalation should never be assumed “safe” simply because cannabis is legal
Patients must weigh symptom relief against long-term pulmonary risk, ideally with informed medical input.
Cannabis, Medications, and Real Risks
One of the most critical—and often ignored—issues is drug interaction.
Cannabis (especially THC and CBD) interacts with liver enzymes responsible for metabolizing many medications, including:
- Biologics
- DMARDs
- Seizure medications
- Psychiatric medications
These interactions are not theoretical. Patients—especially children—have ended up hospitalized due to unrecognized cannabis-drug interactions.
In the U.S., federal Schedule I status severely restricts research and physician guidance, leaving patients to figure this out largely on their own .
What Happened at EULAR?
At EULAR, a formal debate asked whether rheumatologists should prescribe cannabis.
Key points raised:
- Evidence shows modest short-term benefits for pain, sleep, and anxiety
- Potential to reduce opioid reliance is significant
- Concerns remain around cognition, dependency, cardiovascular effects, and lung health
- Physicians acknowledged that all treatments carry risk, including standard rheumatology medications
The conclusion? Interest is growing, but evidence isn’t yet strong enough for widespread prescribing. Most experts emphasized regulation, education, and shared decision-making .
Go With Us! to EULAR 2025: Should Doctors Prescribe Cannabis for Autoimmune Disease?
In this Go With Us! video from EULAR 2025, Eileen Davidson breaks down one of the most talked-about sessions of the conference—a debate on whether cannabis should be prescribed for rheumatic and autoimmune diseases like RA, fibromyalgia, and scleroderma.
Practical Advice from Patients and Experts
Across the discussion, consistent guidance emerged:
- Start low and slow
- Track symptoms carefully
- Treat cannabis like any other medication
- Avoid unregulated or gas-station products
- Consider cost—quality cannabis is expensive
- Never replace prescribed medications without medical guidance
- Understand terpenes and cannabinoids affect people differently
- What helps inflammation may worsen heart rate, anxiety, or tremors in others
For many patients, cannabis works best as a complement, not a replacement, to standard care
The Bottom Line
Cannabis is not a cure. It’s not harmless. And it’s not going away.
For many people living with AiArthritis, it has become another tool—sometimes a crucial one—in managing symptoms that conventional medicine still struggles to control.
What patients need most now is:
- Better research
- Honest medical conversations
- Clear safety guidance
- Legal frameworks that prioritize patient protection over politics
AiArthritis will continue to center patient voices in this evolving conversation—because patients are already using cannabis, whether the system is ready or not .
Tune into the AiArthritis Voices 360 Talk Show, where patients, doctors, and advocates come together to discuss the latest in autoimmune and autoinflammatory arthritis.
