Treating Chronic Pain With Medical Marijuana

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Medical marijuana


Recent research shows that cannabis can effectively treat chronic pain. Pain is a medical condition that's often underestimated. Chronic pain, apart from producing physical discomfort, can also have a big psychological impact on patients, and current medication is extremely limited. Could cannabis be the painkiller of the future?

Recent research shows that cannabis can effectively treat chronic pain. Pain is a medical condition that's often underestimated. Chronic pain, apart from producing physical discomfort, can also have a big psychological impact on patients, and current medication is extremely limited. Could cannabis be the painkiller of the future?

We often think of pain as a relatively simple symptom. After all, it’s the telltale sign that something isn’t quite right with our body. In most every-day cases, pain is simple to treat with basic over-the-counter pain medication. But what happens when pain becomes chronic?

Chronic pain is an extremely complex condition that affects over 1.5 billion people across the world. In the US it is the most common long-term disability and affects over 100 million Americans.

Unfortunately, our methods of treating pain haven’t advanced as much as other aspects of modern medicine. The two go-to treatments for treating pain include non-steroidal anti-inflammatory drugs like ibuprofen or opium derivatives like morphine, both of which have a long list of limitations.

But, thanks to new research, this is slowly changing. New investigations into medical cannabis show that medical-grade weed can offer very effective relief from various types of chronic pain. Could cannabis be the future of treating pain across the world?

UNDERSTANDING PAIN

While pain seems like a very simple condition, diagnosing and treating it correctly can be a real challenge for medical professionals.

Pain is often categorised as acute (short-term) or chronic (long-term).

Acute pain is usually sharp and immediate and can last anywhere from just a few moments to months. Acute pain usually disappears soon after treating the underlying cause of the pain, and shouldn’t last longer than 6 months.

Chronic pain, on the other hand, can last for years. It tends to stick around even after treatment, and the root cause of chronic pain is usually hard to diagnose. While some chronic pain can be the result of a long untreated condition, some can also be present with no obvious damage or injury to the body.

Chronic pain

In most cases, finding the cause of acute pain and an adequate treatment is simple. However, dealing with chronic pain can be much more difficult. This is because the underlying cause/causes behind why a patient experiences pain is/are usually much harder to identify and hence more difficult to treat correctly.

HOW DO WE EXPERIENCE PAIN?

Pain signals are picked up by nerves around the body and travel to the brain via the central nervous system. While we experience pain in many different forms, it is usually grouped into the following 2 categories:

- Nociceptive: Nociceptive pain is usually caused by injury to skin, muscles, visceral organs, joints, tendons, or bones. Nociceptive pain is further broken down into somatic and visceral pain. The former is usually described as musculoskeletal pain (like the pain of grazing your skin), while the latter usually affects the visceral organs and is generally caused by stretching or inflammation rather than bruising or cutting.

Nociceptive

- Neuropathic: Neuropathic pain usually affects the sensory nervous system and is usually characterised by sensory abnormalities. Neuropathic pain isn’t sharp like most nociceptive pain; instead, it can include feelings of hypersensitivity, numbness, or tingling.

Neuropathic

It is important to note that these two categories can overlap. There are many conditions and injuries that affect both the musculoskeletal and nervous systems and can, therefore, produce both nociceptive and neuropathic pain.

WHAT CONDITIONS PRODUCE CHRONIC PAIN?

There are countless conditions that produce chronic pain. However, some of the most common include:

- Arthritis
- Cancer
- Multiple sclerosis
- AIDS
- Nerve damage
- Fibromyalgia

THE PSYCHOLOGICAL IMPACT OF PAIN

When we think about pain, we often think about the physical discomfort we feel around our body. However, it is important to note that chronic pain can also have a serious psychological impact.

Psychological impact

Chronic pain puts the body under a lot of constant stress. Apart from the obvious discomfort, chronic pain can disrupt a person’s sleeping patterns, mood, motivation, and much more. Living with chronic pain is difficult, and sometimes treatment can put a patient under even more stress. In some people, these factors can lead to more serious mental conditions, such as anxiety or even depression.

TRADITIONAL PAIN MEDICATIONS/TREATMENT

The most common way to treat pain these days is with anti-inflammatory drugs like ibuprofen and aspirin or prescription opiates such as codeine and morphine. While anti-inflammatory drugs work to reduce the production of chemicals that cause inflammation in our bodies, opiates suppress pain signals produced by the body’s peripheral nerves.

Cannabis versus traditional

Prescription opiates are the most used form of medicine for treating both acute and chronic pain. In fact, US health care providers gave out close to 250 million prescriptions for opioid pain medication in 2012, which is enough to supply every American citizen with a bottle of pills.

Both anti-inflammatory drugs like ibuprofen and opiate-based medications like morphine have their limitations. Anti-inflammatories are great for treating acute pains that come for instance with headaches but offer no relief from chronic conditions. Meanwhile, opiate-based medicines provide faster and stronger effects, but have a wide variety of side effects that make them unsuitable for extended use in patients with chronic pain.

The biggest concerns about the prolonged use of opiate-based painkillers are tolerance, abuse, and addiction. The number of prescriptions for opioid medication given out across in the US has skyrocketed over the last years, from 76 million in 1991 to nearly 207 million in 2013.

Pain killer

The fact that opioids are easier to access than ever before which has lead to an increase in opiate addiction and overdose deaths. For example, in the US the estimated number of emergency department visits involving the nonmedical use of opioid painkillers increased from 144,600 in 2004 to 305,900 in 2008. The number of deaths caused by an overdose of prescription opioid pain relievers has more than tripled in the past 20 years.

Many patients can quickly develop a tolerance to opioids over time, which makes the opioids ineffective at treating chronic pain. A result of this is that the patient will then most likely up their doses in the hope to get an adequate relief from their symptoms. But this higher dose then exposes patients to a greater risk of side effects (such as constipation, drowsiness, nausea, and vomiting).

CAN CANNABIS TREAT PAIN?

The evidence for cannabis as a pain reliever is strong. The plant contains a wide variety of compounds, which have analgesic properties and also work as anti-inflammatories and much more.

When we consume medical marijuana (either by smoking, vaporizing, or eating it), the compounds within the plant interact with our body’s endocannabinoid system. This system, made up of a variety of receptors located across the brain and body, plays an important role in managing a wide variety of physiological processes, such as memory, appetite, and pain management.

Cannabis contains over 100 active compounds (known as cannabinoids) as well as a variety of terpenes, which boast various medical benefits of their own. The two most well-known cannabinoids are THC (tetrahydrocannabinol) and CBD (cannabidiol). The former is renowned as the plant’s primary psychoactive compound, and both are making headlines for being useful in the treatment of everything from epilepsy to PTSD.

Pain Cannabis

In 1997, a paper in the European Journal of Pharmacology first showed that the endocannabinoid system plays an active role in managing pain. Today, more research shows that cannabinoids like THC and CBD may offer effective pain relief without some of the limitations of opiate-based medicines.

But the research for cannabis’ efficiency as a painkiller luckily didn’t end there. A 2010 study published in the Canadian Medical Association Journal investigated the effect of smoked cannabis on pain. The study required adult patients with postsurgical neuropathic pain to smoke cannabis of varying THC concentrations 3 times daily via a pipe for 5 days.

The patients were asked to classify the intensity of their pain using a numeric scale, while the researchers also investigated the effect the cannabis had on sleep, mood, and more. The study concluded that a single inhalation of cannabis with roughly 10% THC taken 3 times daily not only reduced pain intensity but also improved sleep. The medication was well tolerated by all participants.

More recently, a 2016 study from the Clinical Journal of Pain found that cannabis reduced pain and improved functional outcomes in over 270 patients suffering from chronic pain. The study used a survey to gauge the patients’ pain severity, change in opiate consumption, and more. The study found that the use of medical marijuana in these patients not only greatly reduced the severity of their pain and the level to which it interfered with their lives, but also helped them become more functional. Medical cannabis use also drove down the use of opiates by over 40%.

THC and CBD

However, THC and CBD aren’t the only compounds within cannabis that may help to relieve pain. In the last few years also other cannabinoids such as cannabichromene (CBC) and cannabinol (CBN) have been noted for their anti-inflammatory and sedative qualities, which may make them a feasible option for treating inflammatory conditions like arthritis or pathologies with hard-to-treat chronic pain symptoms like fibromyalgia.

Terpenes such as beta-myrcene, alpha-pinene, and beta-caryophyllene, have also been shown to have analgesic and anti-inflammatory effects, which may also contribute to cannabis’ potential to treat chronic pain.

COULD CANNABIS BE THE PAIN MEDICATION OF THE FUTURE?

In certain places, cannabis is already (slowly) becoming the pain medication of the future. In the parts of the US with legal medical marijuana programs, pain is one of the main approved conditions. This includes states like Alaska, Arizona, California, Illinois, Montana, and many more.

Cannabis USA

Outside the US, medicinal cannabis is also legal in Canada, Australia, Chile, Argentina, Croatia, and many other places. However, chronic pain is not always an approved condition under all medical marijuana programs. To find out more about how to access medical marijuana for pain relief, consult your local laws.

Unfortunately, we still don’t fully understand cannabis and how it affects us and what role it can exactly play in modern medicine. Most of the research we have on hand is just beginning to scratch the surface of an iceberg that is sure to keep researchers busy for many years to come.

However, what we do know is that cannabis, when taken responsibly and administered correctly, can be a powerful medicine with amazing benefits. It’s only a matter of time before we are fully able to uncover the mysteries of this incredible plant.

 

         
  Steven Voser  

Written by: Steven Voser
Steven Voser is an Emmy Award Nominated freelance journalist with a lot of experience under his belt. Thanks to a passion for all things cannabis, he now dedicates a lot of his times exploring the world of weed.

 
 
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