Is Cannabis the Answer for Chronic Pain?

Christine Colbert January 21, 2020 0 comments

For many living with chronic pain, cannabis may be a safer and more effective option than opioids.

Recently, the National Institutes of Health awarded a $3.5 million grant to study cannabis and chronic pain. Alone, such an action speaks volumes to the increasing consideration of cannabis to treat pain. Other studies have also shown the therapeutic potential of cannabis in treating those living with chronic pain.

Take this study for example, published in CMAJ (2010). It states, “A single inhalation of 25 mg of 9.4 percent tetrahydrocannabinol [THC] herbal cannabis, three times daily, for five days, reduced the intensity of pain, improved sleep and was well tolerated.”

In 2017, the National Academies of Sciences also identified supporting evidence. “In adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms.” This report illustrates that as more cannabis research continues to trickle in, a consensus is slowly becoming a possibility.

And yet, there are still confusing arguments on the efficacy of cannabis to help people manage chronic pain. Which might lead one to ask: Is daily consumption of cannabis helpful in treating pain? Or is the answer still unknown?

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What we Know about Cannabis and the Endocannabinoid System

Pain is incredibly complex, and there are numerous different kinds. Inflammatory, neuropathic, and cancer-related pain are just a few of the most common types. In addition, everyone experiences pain differently. But, new clinical data continues to emerge regarding pain and how it’s transmitted. Basically, it’s all to do with the endocannabinoid system.

Researchers are gaining a greater understanding of how this system works in regard to pain. In fact, medical scientists recently studied a woman living pain-free due to a mutation in her endocannabinoid system.

We now know that activation of cannabinoid receptors, like CB1 and CB2, can help reduce symptoms of pain. So can the inhibition of the release of glutamate and other inflammatory agents. THC and CBD target endocannabinoid receptors to relieve pain. Opioids also work down similar pathways to manage pain. This explains the fast rise in prescriptions of opioids for pain in the past few decades.

older female adult living with chronic pain

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A Better Option than Opioids?

Is daily, long-term consumption of cannabis harmful to your health? The short answer is, ‘no.’ Of course, it’s not as simple as that. It depends on what cannabinoids the patient is consuming.

A study in Pain Medicine (2009), identified the potential harms of chronic cannabis consumption. These included alterations in cognitive and motor function, as well as perception. We also know that too much THC can make the pain cycle worse. It can also cause cannabinoid hyperemesis syndrome in some unique cases.

However, these adverse effects seem to be largely associated with cannabis that is high in THC. Side effects from daily CBD consumption are much lower. Studies have confirmed a favorable safety profile for CBD.

But when considering the side effects of daily THC consumption, are they more risky than those presented by opioids? In a word, no. A review in Cannabis and Cannabinoid Research (2017), stated that: “The aberrant use of opioid medications is a growing public health crisis.” They also cited the startling statistic that increased consumption of opioids in the U.S. led to a quadrupling of opioid-related deaths over the fifteen years preceding that review.

These researchers also found that opioids are not optimal for treating pain in the long-term. Not only do patients quickly develop a tolerance to, and dependence on, the drug, it can also dysregulate pain mechanisms over time. This creates an imbalance in pain facilitation.

Studies suggest that CBD can help alleviate symptoms of opioid withdrawal and it decreases opioid dependence. Research has also found that patients report greater pain relief when taking cannabis in combination with opioids, rather than taking opioids alone.

older man no longer living with chronic pain as he rides his bike down a pretty path

What Research Says about Daily Cannabis Consumption for Chronic Pain

Even the most common pain relievers, such as NSAIDS like Motrin or Advil, carry risks with long-term daily use. Such risks include heart attack, stroke, and stomach ulcers. And we know that opioids exhibit severe, even deadly adverse effects. So, when confronted with long-term chronic pain, which option is less harmful to a person’s health?

Unlike opioids, cannabis isn’t addictive. Heavy consumption can cause a mental dependence, but withdrawal symptoms are mild in comparison with opioids. Those short-lived symptoms typically only occur after cessation of overconsumption of cannabis high in THC.  And unlike other pain management drugs, it’s impossible to overdose on cannabis.

At present, there is a need for more research on the long-term efficacy of cannabis to treat pain. The scientific evidence is still in its infancy. But even so, more and more patients are choosing cannabis to treat pain. A recent review published by the International Association for the Study of Pain (2018) found that cannabis produced a thirty percent reduction in pain in various studies. And it did so without significant impact to physical or motor functioning.

With scarce data on long-term human trials, we can only rely on what we currently know. Cannabis isn’t addictive, adverse effects are minimal, and it does not increase sensitivity to pain. With that information, we can surmise that long-term consumption is safer than opioids, and may even be a better alternative than NSAIDS. And more importantly, as we’ve seen from increasing research and anecdotal reports, cannabis is an effective option for long-term pain relief. So why not try it? Those in legal areas and living with chronic pain might suddenly experience a higher quality of life.