Can medical marijuana help to alleviate different types of pain?

by Dr. Corey Jaquez
in Blog
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Today, chronic pain affects more people than all cancers, cardiovascular disease (heart attack and stroke), and diabetes COMBINED. In addition to a strikingly high prevalence, chronic pain also has a major economic impact as it is the most common cause of long-term disability in the United States. Of course, the most often prescribed pharmaceuticals to combat this issue come at a very high physiologic cost: addiction and tolerance.

Over time, not only does a patient become tolerant to these medications (needing higher doses of the medication for the same or LESS effect), they are also at very high risk of becoming addicted to them. This double whammy has significantly contributed to the current opioid epidemic that grips the United States. A potential silver lining does exist, however, in the form of medical cannabis. To best understand the solution, it is imperative that we better understand the problem- Pain.

Pain comes in several different forms. Nociceptive Pain: Typically results from tissue injury like a sports injury, an accident, or other forms of trauma. Inflammatory Pain: Arises from an increased sensitivity to pain due to an inflammatory response. The increased sensitization to pain creates a condition where a harmless stimulus can be perceived as painful. Neuropathic Pain: Pain caused by nerve irritation/damage. Neuropathic pain may be associated with abnormal sensations or pain from normally non-painful stimuli due to a damaged nerve cell. Functional Pain: Pain without obvious origin. This is a unique and often difficult diagnostic group. Functional pain disorders can include fibromyalgia, irritable bowel syndrome, and interstitial cystitis.

Of course the question becomes, how can cannabis help? What does it do that helps to alleviate these different pain types? There are many different chemical compounds found within the cannabis plant. The two most commonly examined chemical compounds include THC (tetrahydrocannabinol) and CBD (cannabidiol). THC resembles the cannabinoid chemicals that occur naturally in the body, called endocannabinoids. When people ingest or inhale THC, the brain’s cannabinoid receptors become activated. These receptors are located throughout the central and peripheral nervous system, as well as throughout the body. Cannabinoid receptors within the brain’s reward system help reduce pain levels when activated by THC.

New evidence suggests that cannabis helps relieve pain and the scientific community is starting to demonstrate objective evidence to support this claim. A better understanding of the physiological relationship between the pain pathways and the endocannabinoid system is taking hold. Several recent research papers and reviews have strongly suggested that marijuana or cannabinoids may be effective for treating some types of chronic pain including neuropathy. A research paper from 2016 found that marijuana use for cancer pain led to a 64 % reduction in opioid use, improved quality of life from improvement in other debilitating symptoms, and caused fewer medication side effects. It also led to participants using fewer pharmaceutical medications. Such promising results certainly need to be repeated and proven to be consistent, but any tools to combat chronic pain are welcomed ones.

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