Medical Marijuana for Rheumatoid arthritis: States & FAQ

Quick answer

Yes, in many places. 6 state programs name rheumatoid arthritis on the official list, and 12 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.

6list it by name

12provider's discretion

Moderate evidenceresearch strength

Understanding rheumatoid arthritis

Rheumatoid arthritis, or RA, is an autoimmune disease in which the immune system attacks the lining of the joints, causing pain, swelling and stiffness, often in the hands, wrists and feet. It affects about 1.5 million people in the US and is two to three times more common in women.

RA can make simple tasks like opening jars or getting dressed painful, and morning stiffness and fatigue can last for hours. Treatment centers on disease-modifying medicines such as methotrexate, biologics and JAK inhibitors to protect the joints, along with short-term steroids, anti-inflammatory medicines and physical or occupational therapy.

Symptoms patients hope to ease

Joint pain in the hands, wrists, knees and feet
Morning stiffness that lasts a long time
Pain that disrupts sleep
Fatigue that comes with ongoing inflammation
Pain that lingers even when inflammation is controlled

Does rheumatoid arthritis qualify in your state?

What the research says

Moderate evidence. Joint pain is covered by the chronic pain evidence; RA-specific trials are small.

A small randomized trial of a THC and CBD mouth spray in people with RA found improvements in pain with movement, pain at rest and sleep quality compared with placebo.
The 2017 National Academies review found substantial evidence that cannabis can modestly reduce chronic pain in adults, which supports its use for ongoing arthritis pain.
Patient surveys show many people with RA use cannabis for pain and sleep, but some rheumatology groups still consider the evidence too limited for routine use.
Lab studies suggest cannabinoids affect inflammation, but cannabis has not been shown to stop joint damage in people with RA.

Sources: National Academies of Sciences, Engineering, and Medicine, The Health Effects of Cannabis and Cannabinoids (2017); FDA approvals; published trials. General information, not medical advice.

How doctors approach rheumatoid arthritis

Topical creams or balms may be tried on painful hands or knees, with little effect on the rest of the body.
Oral tinctures or capsules taken in the evening are often considered for overnight pain and morning stiffness.
Balanced THC and CBD products are commonly used, with CBD-leaning options during the day to limit impairment.
Starting low, going slow and keeping your disease-modifying treatment on schedule is key.

Risks and precautions

Cannabis does not replace disease-modifying medicines, and stopping them can lead to permanent joint damage.
Methotrexate and leflunomide can affect the liver, and CBD may add to that strain, so ask about liver blood tests.
CBD may raise levels of some RA medicines processed by the liver, such as tofacitinib.
Biologics and JAK inhibitors raise infection risk, and smoking itself is linked to worse RA, so smoking or vaping cannabis is best avoided.
Cannabis can add to the drowsiness of opioids and sleep aids, and CBD can raise levels of blood thinners like warfarin.
Not recommended during pregnancy or breastfeeding, and never drive while impaired.

What to bring to your evaluation

Notes from your rheumatologist confirming rheumatoid arthritis.
Lab results such as rheumatoid factor or anti-CCP, and any joint imaging.
A list of RA medicines you take now and have tried before.
A pain and stiffness diary showing how RA affects your hands, sleep and daily tasks.
A government photo ID and proof that you live in your state.

Don't have records handy? Many patients are evaluated on their history alone.

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How to get certified for rheumatoid arthritis

Answer a few questions
Pick your state, tell us your symptoms and what you've already tried. Review your answers and contact you to schedule your video visit.
Meet your doctor by video
Join from your phone or laptop. Have a photo ID ready. The doctor reviews your history and decides whether cannabis is right for you.
Get certified and registered
Pay the evaluation fee, then submit your state registry form. The doctor files your certification. We walk you through the state form line by line.

Rheumatoid arthritis: 9 common questions

Does rheumatoid arthritis qualify for a medical marijuana card?

Yes, in many places. 6 state programs name rheumatoid arthritis on the official list, and 12 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.

Which states list rheumatoid arthritis as a qualifying condition?

As of our latest check of each state's official list: Connecticut, Hawaii, Illinois, Michigan, New York and North Dakota. Providers can also certify it in Alaska, California, Colorado, Delaware, Florida, Louisiana, Maine, Minnesota and 4 more, which don't use a fixed list. Lists change, so confirm on your state's page before you apply.

Can I get certified for rheumatoid arthritis online?

Yes, in 13 of those states — including Connecticut, Hawaii, Illinois, New York, California and 8 more — your first evaluation can happen by video with a provider licensed there. In 5 others, such as Michigan, North Dakota, Alaska and 2 more, the first visit must be in person, and renewals can usually be done online.

Can cannabis help rheumatoid arthritis pain?

Some evidence suggests it can help with pain and sleep, including a small randomized trial in people with RA. The benefit is usually modest. It works best as an add-on to the medicines that control your RA, not as a replacement.

Can cannabis stop joint damage from RA?

No. Cannabis has not been shown to slow joint damage in people with RA. Disease-modifying medicines such as methotrexate and biologics are what protect your joints over time. Keep taking them as prescribed.

Can I take cannabis with methotrexate?

Methotrexate can affect the liver, and CBD is also processed by the liver. Many people use both, but your rheumatologist may want to check liver blood tests more closely. Avoid alcohol with this combination, and tell your doctor what you plan to use.

Do CBD creams help arthritis in the hands?

Some people find topical products soothing for sore joints, and very little reaches the bloodstream. Research on topical CBD for RA is limited. Try a small amount on one area first and see how your skin and pain respond.

Is CBD or THC better for rheumatoid arthritis?

The best RA study used a product with both THC and CBD. CBD alone may be useful during the day because it does not cause a high, while small amounts of THC may help more with pain and sleep at night. Your doctor can help you find a balance.

Is it safe to smoke cannabis if I take a biologic for RA?

It is best avoided. Biologics and JAK inhibitors lower your defense against infections, including lung infections, and smoking is linked to worse RA. Oral or topical forms are safer choices.

Medical marijuana for rheumatoid arthritis