By: Matthew Morrow
Finding a remedy that adequately controls chronic pain can be difficult. Patients who report experiencing chronic pain often try a variety of medical treatment options before landing on one that is able to improve their situation.
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Cannabis has recently emerged as a potential treatment option for certain types of persistent chronic pain, and has even been proposed by some as a way to reduce opioid use in this population.
Despite the growing interest in this topic, a couple questions remain. Who should try cannabis for chronic pain and what is the safest way of doing so?
Here, we will explore the evidence surrounding the utility and safety of cannabis use for chronic pain.
Does cannabis for chronic pain work?
Chronic pain can originate from a number of origins, ranging from age-related lower back pain to persistent pain associated with a serious medical condition.
Knowing the origin and type of pain that is occurring can be helpful for determining appropriate treatment options.
In general, pain falls into two categories. Pain can be nociceptive, meaning that it is associated with tissue damage in our body.
Pain can also be neuropathic, meaning that it is related to an issue with the nervous system.
These types of pain may exist together, and may also be associated with inflammatory pain, or pain arising from chronic inflammation of various body parts.
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The objective evidence on the topic of cannabis for chronic pain is not robust. Federal guidelines limit the scope of research that can be done, however there is a limited pool of evidence that can be used to make an informed decision.
The growing body of evidence shows that cannabis may help with certain types of pain, like neuropathic pain and pain related to the nervous system disease, multiple sclerosis.
Comprehensive reviews of studies on this topic reveal that although patients using cannabis for chronic pain saw a reduction in pain symptoms, it was only a modest reduction.
Other types of pain that may have some relief with cannabis include cancer-related pain, migraines, fibromyalgia, and some musculoskeletal types of pain.
Until more evidence becomes available, it is difficult to determine if cannabis would work for all patients with these conditions and how various cannabis strains, doses, and forms of administration play a role in pain relief.
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Despite the lack of objective evidence on this topic, there seems to be a rapidly increasing pool of anecdotal reports by patients using cannabis for chronic pain.
Pain is one of the most commonly cited reasons for patients using medical cannabis.
Oftentimes, patients with severe pain that has not been controlled by other treatments are willing to try anything to find adequate relief.
Why does cannabis for chronic pain work?
The exact mechanism in which cannabis acts to control chronic pain is not yet fully understood.
Although our understanding of the complex cannabinoid system in our bodies is still growing, it is still helpful to take a look at the currently available evidence.
We do know that cannabis molecules like THC and CBD act on cannabinoid receptors in the body, named CB1 and CB2.
Activating these receptors has been shown to have pain blocking effects through the regulation of inflammation in the body.
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There are several theories as to how this exactly works, but our understanding remains limited.
Some scientists have proposed that there may be a possible interaction between the cannabinoid system and the opioid systems, however this research is still in early stages.
Whether or not using cannabis can reduce opioid consumption and provide similar pain relief remains a mystery, however this is certainly an emerging and relevant topic today.
How to use cannabis for chronic pain?
When using any substance, it is helpful to consider the possible harms and side effects.
Unfortunately, the adverse effects of cannabis can be hard to predict because of widely variable dosing options and unknown individual factors.
For chronic pain, the limited evidence indicates that most chronic pain relief results from using products with higher THC concentrations.
This would indicate that many strains that provide strong pain relief are likely to come with some psychoactive effects as well.
Although this may not be an issue for some, it is helpful to be aware of the potential side effects before using a substance for the first time.
There is a trusted saying in pharmacology that it is always a good idea to “start low and go slow.” This applies to cannabis use as well.
Most negative side effects from cannabis result from using a dose higher than your body can handle, so taking things slowly at first is a must.
For those with chronic pain, the same concept applies. It would be best to start low and slowly increase both dose and THC content until the right combination is found.
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Further adjustments down the road may need to be made, so becoming familiar with how your body responds to various doses and strains can be useful.
Trying out different strains could also provide great benefit. There is a large variety of strains available, each with their own unique effect profile.
Thus, it is possible to customize your experience based on what symptom relief you need.
Conclusion
Cannabis may be a helpful alternative or adjunct treatment option to traditional medications for some people with chronic pain.
The limited evidence available on the topic makes it difficult to say with certainty that cannabis for chronic pain is a validated and safe option for everyone.
There seems to be a growing amount of anecdotal evidence supporting cannabis for chronic pain, which leaves the topic in a sort of gray area.
It would be best to consult a medical provider to discuss whether trying cannabis for chronic pain might be a good option for each individual on a case by case basis.
Disclaimer: It is always best to check in with your medical provider before initiating the use of cannabis products. The information on this page does not represent medical advice.
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Matthew Morrow is a writer who focuses on health and wellness.