Medical Marijuana and Chronic Pain
Note: The Sanctuary Wellness Institute does not sell any marijuana products or CBD products
The medical marijuana industry is growing across the world. More than twenty-six countries and thirty-six American states have already legalized medical marijuana. As this trend continues, questions regarding its efficacy as a medicine arise.
As legalization for medicinal use continues to spread, researchers are also expanding their research on the cannabis plant. Clinical evidence has revealed chemicals naturally found in marijuana such as cannabidiol (CBD), and the psychoactive cannabinoid tetrahydrocannabinol (THC), can provide relief to patients suffering from chronic pain. In fact, the most common medicinal use of medical marijuana in the United States is for chronic pain. Globally, it is estimated that chronic pain currently affects more than 1.5 billion people. Every single year ten percent of the population are newly diagnosed with chronic pain
Globally, it is estimated that chronic pain currently affects more than 1.5 billion people. Every single year ten percent of the population are newly diagnosed with chronic pain.
A survey carried out between 1990 and 2013 by the Global Burden of Disease Study placed conditions associated with chronic pain among the top contributors to years lived with disability globally.
What Is Chronic Pain?
In retrospect to acute pain which simply warns us of disease or injury, chronic or persistent pain serves no adaptive purpose. The International Association for the Study of Pain states there is no biological purpose to chronic pain, as it will persist past normal tissue healing .
Typical Treatment for Chronic Pain
Mild chronic pain is usually treated with over the counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs). Patients with more severe chronic pain are prescribed opiates.
While this medication is effective at providing those suffering from chronic pain with relief, stronger medications such as opioids are also highly addictive and come with many negative side effects including dependence, an increased risk of heart disease, overdose risk and liver damage .
It’s no wonder that patients and medical professionals are turning to medical marijuana as a solution. Not only is medical marijuana effective, but it is also far safer for patients.
Medical marijuana consumption methods include vaporizing dry herbs and cannabis-based e-juices. Some patients prefer oral ingestion through tinctures, oils, and edibles. Such methods have different onsets and duration of effects. For instance, vaping allows patients to immediately feel the effects of cannabis, whereas oral ingestion takes about 15 to 30 minutes.
The cannabis strain also has something to do with the expected effects. For example, cannabis sativa strains produce euphoria or energy-boosting upshots, whereas cannabis indica strains cause relaxation and sleepiness. In addition, the combination of sativa and indica strains produces an entourage effect because of the synergistic interaction of cannabis compounds (cannabinoids).
You must always seek your doctor’s advice before using medical marijuana for chronic pain or any other condition as it may affect prescription drug effects and overall health. Therefore, professional medical assessment is a must beforehand.
Nowadays, many people also turn to marijuana derivatives, such as cannabidiol or CBD. This compound has different uses in the medical and wellness industries. It’s believed to possess anti-inflammatory and analgesic properties, which may reduce oxidative stress, as well as help with pain management among sufferers of gouty arthritis. CBD for gout may reduce the pain associated with sharp uric acid crystals formation around joints.
The Endocannabinoid System And Chronic Pain Relief
Medical marijuana’s efficacy as a pain killer is due to how it affects the endocannabinoid system, which plays a direct role in the regulation of pain.
The endocannabinoid system is comprised of endocannabinoids, and the receptors these chemicals bind to. These receptors are found throughout the body, in our organs, brain, connective tissues, glands, and immune cells. The endocannabinoid system works on regulating homeostasis, or in simple terms, maintaining a stable internal environment.
Endocannabinoids are at the intersection of the human body’s various systems, allowing the coordination and communication between different cell types. As an example, at the site of injury, endocannabinoids and cannabinoids are found stabilizing the nerve by decreasing sensitizers and activators from the injured tissue to prevent excessive firing (which would cause pain). Endocannabinoids also calm nearby immune cells which prevent inflammatory compounds from being released.
These mechanisms could help explain why ingesting medical grade marijuana helps to alleviate chronic pain. During pain, nerves are firing unnecessarily, coupled with excessive inflammation which damages healthy cells. The cannabinoids found in medical marijuana resemble those produced by our body, and so may help the body maintain homeostasis and thereby relieve pain .
Clinical Evidence for Medical Marijuana Relieving Chronic Pain
Current evidence for medical marijuana decreasing chronic pain is strong. A study released in the Journal of the American Medical Association reviewed 28 randomized clinical trials. The researchers discovered patients experienced significant improvements in every pain-related study, and stated that the “use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence”. A research paper exploring the effects of medical marijuana on cancer pain discovered a 64 percent reduction in the use of opioids for pain .
Despite the plethora of evidence supporting marijuana for chronic pain, there is limited research surrounding strain specific recommendation for chronic pain. But we do have anecdotal evidence from surveys.
Best Marijuana Strains for Chronic Pain
There are three classifications of marijuana strains:
- Cannabis indica
- Cannabis sativa
An online survey featured in the Journal of Alternative and Complementary Medicines found participants opted for indica strains for the management of pain, primary due to its sedentary effects which aided in promoting sleep .
In regards to pain management, those who completed the survey reported significant improvements when using indica varieties for:
- Joint pain
- Non-migraine headaches
One of the two primary cannabinoids in marijuana – cannabidiol (CBD) – is non-psychoactive, meaning there is no euphoria or “high” after ingestion. Tetrahydrocannabinol (THC) – the psychoactive cannabinoid) – attaches to receptors of the endocannabinoid system in the brain, producing a psychoactive effect. CBD instead affects CB2 receptors throughout the body, which helps to decrease inflammation and inflammatory-related pain .
Medical marijuana is clearly beneficial for people suffering from chronic pain. Which type of medical marijuana product is best for pain is subjective to the individual. However, based on the evidence, surveys indicate that CBD is likely best for inflammatory pain, as well as indica strains of cannabis which tend to be more sedative and beneficial for pain relief.
Kirstie is a Certified Cannabis Coach with over 10 years in the medical cannabis field. She has worked at The Sanctuary Wellness institute since 2021 and has helped countless patients with questions pertaining to medical cannabis.