Sickle cell disease (SCD) is a rare blood disorder that causes red blood cells (RBCs) to become hard, sticky, and crescent-shaped, like a sickle. These RBCs can get stuck in blood vessels, causing pain, stroke, infections, and other serious cardiovascular issues.

The only potential cure for SCD is a bone marrow transplant, which carries serious safety risks. Standard treatment includes pain medications, stem cell therapy, and blood transfusions.

If you have more severe pain from SCD, a doctor may prescribe opioids like morphine, but these medications have risks, like addiction and overdose. For this reason, scientists are seeking better ways to manage SCD-related pain.

Evidence is growing that cannabis may help people manage pain from SCD. If you have SCD, cannabis isn’t a cure but could improve your symptoms.

Read on to learn more about whether cannabis could alleviate pain from SCD and if it’s right for you.

Cannabis is a drug from the hemp plant (Cannabis sativa). It’s more commonly called marijuana, weed, or pot.

Cannabis contains many cannabinoids, including tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the main psychoactive component. THC is what gives you a euphoric high.

After entering the body, cannabinoids mainly act on two receptors: the cannabinoid-1 (CB-1) receptor and cannabinoid-2 (CB-2) receptor. These receptors are found in the central nervous system and the immune system.

Receptors are tiny proteins on cells that receive signals from substances like hormones or drugs. They help your cells respond appropriately. The activation of these receptors helps regulate pain and inflammation, both of which are symptoms of SCD.

THC also triggers your brain to release large amounts of dopamine. Dopamine is a naturally occurring pleasure chemical. It influences your mood and feelings of “reward.” By activating the brain’s reward system, THC could reduce your perception of pain.

A survey conducted in 2018 of 58 adults with SCD found that 42 percent of participants had used cannabis within the previous 2 years. The main reasons for using cannabis were to reduce pain, relieve anxiety, and help with sleep or mood. The authors concluded that survey results warrant more research on cannabis use for pain relief in SCD.

Studies in mice with SCD also found that cannabinoids appeared to reduce pain. A more recent study in mice with SCD looked specifically at the drug Epidiolex, a 99% pure extract of cannabidiol (CBD). In the study, CBD improved acute and chronic pain in SCD-affected mice.

Based on these results, researchers thought it would be helpful to conduct clinical trials to understand whether this effect is true in people with SCD.

A 2020 study published results of the first clinical trial to examine the use of medical cannabis for alleviating pain in people with SCD. In the double-blind, placebo-controlled proof of principle study, 23 participants with SCD either inhaled vaporized cannabis or vaporized placebo three times a day. The cannabis used contained equal ratios of THC and CBD.

The study found no significant difference in pain reduction between the cannabis and placebo groups but did find that patients in the cannabis group experienced a significant improvement in mood.

Mood disorders, like depression and anxiety, are common in people with SCD, so this finding is important. But more research will be needed to study the effect of cannabis in treating anxiety and depression in people with SCD to confirm this benefit.

As the study period progressed, some participants reported that their pain interfered less with activities, including walking and sleeping, but the difference wasn’t statistically significant.

A retrospective analysis of people with SCD who obtained medical marijuana certification found that people who purchased medical cannabis were admitted to the hospital less frequently than those who did not use medical cannabis.

Research summary

Research on the benefits of cannabis to treat pain from SCD is limited, but studies in mice, surveys of people with SCD, and one small clinical trial suggests cannabis has the potential to:

  • reduce pain
  • improve mood and relieve anxiety and depression
  • reduce hospital admissions
  • reduce the need for other pain medications, like opioids

In at least one 2020 study conducted so far in people with SCD, cannabis use had no significant side effects compared with the placebo group.

Researchers are hopeful that cannabis might help address the public health crisis related to opioids. But long-term studies with more participants are needed to better understand the risks.

It’s important to know that cannabis use combined with opioids is linked to an increased risk of opioid misuse. If you’re already managing SCD pain with opioids, talk with your doctor before starting cannabis.

You can purchase medical cannabis in various forms, including:

  • dried plant for smoking
  • cartridges for vaping
  • edibles (baked goods, candies, or capsules)
  • oils
  • extracts
  • topicals
  • patches
  • liquids/tinctures

Only one controlled clinical trial has studied the benefits of cannabis in people with SCD. This study used vaporized cannabis.

But a 2020 survey reported that many people with SCD smoke medical marijuana or consume edible products. Inhaled cannabis had a quicker onset, but edibles provided longer-lasting pain relief.

More research is needed to find out whether cannabis delivered in other forms, such as extracts, can also help treat pain from SCD.

Here are answers to some common questions about cannabis and sickle cell disease.

Are any cannabinoids approved by the FDA to treat pain from sickle cell disease?

No, the Food and Drug Administration (FDA) hasn’t approved cannabinoids to treat pain from sickle cell disease.

Cannabinoids are FDA-approved only in the United States to treat two rare forms of epilepsy. More specifically, the cannabidiol (CBD) prescription drug Epidiolex is approved for Lennox-Gastaut syndrome and Dravet syndrome. The FDA hasn’t approved Epidiolex to treat SCD.

A study in mice with SCD found evidence that Epidiolex has the potential to reduce or prevent pain. Clinical trials are needed to determine if this effect translates to humans before the FDA considers approving it.

Is medical cannabis legal in my state?

Legal access to medical marijuana is slowly becoming more common in the United States. According to ProCon.org, as of June, 37 states and the District of Columbia allow marijuana for qualifying medical conditions.

But only nine states include sickle cell disease as an approved health condition for medical marijuana. Another 19 states, two territories, and the District of Columbia allow cannabis for adult nonmedical use.

Check with your state’s health department to see whether you qualify for medical cannabis in your area.

I have SCD. Can I get cannabis from my doctor?

Since medical cannabis is federally regulated, your doctor can’t prescribe it for you. Instead, your doctor can certify with the state that you have SCD as a qualifying condition. Decisions about medical cannabis use are made between the patient, the state, and the cannabis dispensary.

Is cannabis safe for people with sickle cell trait?

Sickle cell trait (SCT) isn’t a disease. If you have SCT, you have inherited the sickle cell gene from only one parent. People with SCT don’t have symptoms of SCD and typically live a “normal” life.

Cannabis is likely just as safe for people with SCT as it is for the general population. Cannabis does carry risks. It can cause changes in perception and increased heart rate and may also impair your memory. Smoking cannabis may cause chronic cough and other toxic lung effects over time.

With cannabis becoming a popular way to manage pain, several states now regulate cannabis to treat pain caused by various conditions, including SCD. More research is needed, but studies so far show that cannabis has the potential to improve mood and pain from SCD.

Talk with your doctor if you have SCD and want to consider cannabis as part of your treatment plan. If your state has approved medical cannabis to treat SCD, you will also need to reach out to a regulated dispensary to see if you qualify for a medical marijuana card.

Is CBD legal?The 2018 Farm Bill removed hemp from the legal definition of marijuana in the Controlled Substances Act. This made some hemp-derived CBD products with less than 0.3 percent THC federally legal. However, CBD products containing more than 0.3 percent THC still fall under the legal definition of marijuana, making them federally illegal but legal under some state laws. Be sure to check state laws, especially when traveling. Also, keep in mind that the FDA has not approved nonprescription CBD products, and some products may be inaccurately labeled.