Sick of side effects from traditional pain medications? Patients with chronic pain are finding real results with cannabis.
For people with chronic pain, simply getting through each day can be a struggle. Pain takes a physical toll, but it also has a huge emotional impact – often causing fatigue, anxiety and depression. Narcotic painkillers can provide powerful relief for some types of pain. Neuropathic pain (often experienced by those with conditions such as multiple sclerosis and diabetes) can prove to be tricky, as it doesn’t respond to many conventional pain medications.
Even if a patient’s pain is well-controlled with traditional medications, the side effects often cause an entirely different set of health problems. Over-the-counter medications such as non steroidal anti-inflammatory drugs (NSAIDS) seem harmless but cause stomach issues and kidney damage if taken over long periods of time. Narcotic medications such as opioids are most often used for extreme chronic pain. In the short-term, many patients can find it difficult to go about their daily lives while taking opioids, as the sedation and dizziness make it dangerous to drive hard to concentrate. Nausea and constipation cause opioid users to add additional medications into their regime to combat their upset stomachs. Over time, tolerance and addiction become very real concerns – making opioids incredibly dangerous for long-term use.
Cannabis as a Pain Reliever
Concerns about side effects and dependence – particularly with opioid painkillers – has led many people to consider cannabis as a treatment for their chronic pain. Over the years, there has been much anecdotal evidence that cannabis is beneficial for those who suffer from a variety of painful conditions. Now, research studies are starting to produce hard evidence that this is the case. McGill University in Montreal compared cannabis to a placebo and found that it helped reduce pain in those with chronic nerve pain. They achieved this through taking three puffs a day of cannabis with levels of THC that ranged from 2.5% to 9.4%. The best relief came from the cannabis with the highest THC. Participants noted that the cannabis did not completely alleviate their pain but significantly reduced it and made it more bearable.
Scientists are constantly conducting new research to find out more about the mechanisms through which cannabis helps treat certain conditions and symptoms. Studies that have been released so far show a connection between the endocannabinoids that occur naturally in the brain and our reaction to things such as pain and external stimulation (in people with ADHD or anxiety). Endocannabinoids also help control our overall mood and behavior. Cannabinoids like THC and CBD that are found in cannabis can bind with the brain’s receptors and act similarly to endocannabinoids. This means that they can do things like reduce pain, provide a sense of calm and well-being, and increase focus, among other things. The effects of cannabis depend on the ratio of THC to CBD, as each cannabinoid acts differently on the brain.
A Look at Addiction
For many people, talk of cannabis leads to concerns about addiction – either addiction to cannabis itself or the patient moving on to harder substances. In a September 2016 article in the Boston Globe, Dr. Uma Dhanabalan discussed how despite the general miseducation about cannabis as being a gateway to stronger substances, it’s helping many people with chronic pain break their dependence on pills. “Cannabis is not an entrance drug”, she said, “it is an exit drug from pharmaceuticals and narcotics”. In fact, cannabis is being used in drug-addiction programs to help treat those with opioid addiction get off of hard and dangerous substances such as heroin.
Even for people who aren’t in addiction programs, studies suggest that there may be a link between access to medical marijuana and less overall dependency on opioids. This translates into a lower number of opioid-related deaths due to overdose and driving accidents. A 2014 study for JAMA Internal Medicine found that in states with legal access to medical cannabis, addiction to opioids dropped 25% compared to states where medical cannabis remained illegal. Researchers at Columbia University discovered that a link between legalized medical cannabis and a drop in vehicular fatalities where opioid intoxication was the cause. Statistics have shown that doctors in these states wrote fewer prescriptions for pain medications.
All of these numbers are good news for patients with chronic pain, but they’re bad news for pharmaceutical companies who are concerned about their bottom line. As medical cannabis has become legal in more places, companies that sell prescription opioids have begun a loud and vocal lobby against it. In addition to pushing against legalization, drug companies have argued against a reclassification of THC that would allow it to be researched more thoroughly. Because of the continued difficulties surrounding access and research, this makes it tough for patients to know exactly what product will work best for their specific condition.
Patients Must Have Patience: The Learning Curve
Patients with chronic pain often find themselves in a world where they must educate themselves and work to figure out which strains best relieve their symptoms. While doctors are allowed to suggest cannabis as a treatment for pain, they aren’t allowed to prescribe specific strains. Some strains may reduce inflammation. Strains that are high in CBD and low in THC work to reduce physical pain without the “mind high” that is often associated with marijuana. Individuals must also experiment with dosages to discover what works best for them. Some people find that taking small doses throughout the day helps to provide sustained relief without affecting their mental clarity. Others take a dose at night in order to help them get restful, uninterrupted sleep.
Depending on legality and availability, there are many intake methods for patients who are using medical cannabis for pain relief. One of the most common delivery methods is smoking. One puff delivers results within just a few minutes and will peak over 15 minutes. For those who have lung issues or who aren’t comfortable with smoking, there are a variety of other ways to get relief.
Edible cannabis is a subtle and simple way to take cannabis. It takes longer to act than smoking – anywhere from 60 to 90 minutes after eating a cannabis-infused treat. For those who prefer taking medication in pill form, cannabis oil pills are convenient and easy. Cannabis tinctures such as sprays and drops are taken orally and work similarly to edible cannabis, taking over an hour to work. Cannabis can also be delivered via transdermal patches.
Working with one’s healthcare provider is incredibly important when starting any new medication regime. Many pain medications require that the user taper off of them and not stop them cold turkey. It’s also important to avoid any unpleasant or dangerous interactions between cannabis and any medications you’re currently taking. Even if your doctor can’t prescribe cannabis or suggest any specifics around its administration, make sure they know that you’re planning on embarking on this medical journey before you start. As you begin to discover which strains work best to provide relief, the process will likely also provide much-needed education to your doctor – something that will help ensure that soon, medical cannabis is easily and legally available to all who need it.