Cannabis And CBD For Chronic Pain

Cannabis And CBD For Chronic Pain

My introduction to the use of medical cannabis (medical marijuana), as something being used for something other than getting “high”, was for pain relief.

In 2012 voters approved the use of medical cannabis in my home state of Massachusetts. By 2015 the first dispensaries opened. At that time I had thought that the only medical uses of cannabis was for the treatment of anxiety, uncontrolled seizures and to help reduce the tremors for those with Parkinson’s. I was not aware of other possible uses. It only when a family member was deal with chronic pain that I discovered that cannabis has many other uses.

For me, having someone I love in pain on a daily basis sent me searching for alternative solutions . All the usual medications were tried in order to provide some relief from the pain including anti-inflammatories, steroids (both pills and injections) and various narcotic as well as over the counter pain medications. Some had more effect than others. There were the hand splints and using hot/cold packs to help relieve the pain of hand arthritis. But the pain, stiffness and joint deformity slowly grew no matter what was tried. While researching other methods of pain relief I came across an article discussing the use of cannabis and CBD for chronic pain and so began my journey into the world of medical cannabis.

What is chronic pain?

 

Chronic pain is that continues beyond what you would expect for a particular illness or injury. The pain can continue on for months or even years longer than what is normally expected.

In 2016, an estimated 50 million U.S. adults were suffering from chronic pain and almost 20 million had high-impact chronic pain (chronic pain that frequently limits life or work activities). That’s a whole lot of people suffering in pain on a regular basis with over 8% of the population being in so much pain that it prevents them from working or performs activities of daily living. With that many people in pain is it any wonder we have an opioid crisis?

What are the effects of chronic pain?

For those suffering in pain their goal is to reduce the pain as much as possible so they can function and to avoid the side effects found with using pain medications. Not treating the pain has serious consequences including but not limited to the following:

• limited ability to move

• lack of energy/tiredness

• changes in appetite

• anger

• depression

• increased anxiety

• suicidal thoughts

• problems with sleeping

• increased tension

• increased blood pressure

And many other issues such as problems with jobs as well as causing relationship (and even sexual) issues. Chronic pain doesn’t just affect the part of the body that was injured. The consequences reach into every aspect of the chronic pain sufferer’s life.

What are conditions that can cause chronic pain?

Some of the leading causes for chronic pain include:

• surgery

• back problems

• migraines

• nerve damage

• arthritis

• infections

• fibromyalgia

How can cannabis / marijuana help with chronic pain symptoms?

Cannabis plays two important roles in helping to relive chronic pain symptoms. First it can provide relief from the pain itself. Second it can provide relief from the side effects (such as nausea, vomiting or dizziness) of taking other drugs to assist with the conditions causing chronic pain, cancer and other conditions.

Use of opioid pain medications can cause many side effects such as nausea, vomiting, lightheadedness, dizziness, constipation and shortness of breath. Taking large doses or mixing opioids with alcohol can slow down your breathing which can be potentially fatal. Let’s not forget the psychological as well as physical dependence that can occur from using them. Cannabis can help to reduce some of these side effects and even allow for the reduction of pain medications.

Many of the therapeutic benefits of cannabis are well known and medical researchers are discovering new things every day. While cannabis had been classified as a a schedule 1 drug (Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse) there are a variety of drugs currently on the market that contain synthetic versions of the chemicals already found in cannabis.

Synthetic Cannabis Drugs Currently On The Market:

Dronabionl/Marinol which contains synthetic Delta-9 THC and is used in the treatment of nausea and vomiting, as an appetite stimulant and as an analgesic for neuropathic pain.

Nabilone/Cesamet which contains a synthetic cannabinoid similar to THC and is used in the treatment of nausea and vomiting in cancer patients.

Epilodex which is the first cannabis based drug that has just been approved for use for two types of seizures. The last article I read about this new drug is the average yearly price will be around $32,000 a year! Which is just insane when you think about the cost of cannabis.

So how can it be considered a substance with no currently accepted medical use if the pharmaceutical companies have produced medications that are supposed to have beneficial effects on the body from cannabis?

Legalized Cannabis By State:

Thankfully the states are catching on quicker than the federal government. Currently there are 33 states that have passed laws to legalize cannabis in some form. At some point I hope that the medical benefits of cannabis finally get the laws changed on a federal level.

Check out this interactive map to see state by state information on the recommendations of cannabis for medical use.

The Endocannabinoid System (ECS)

When you go through school you are taught the systems of the body…..digestive system, nervous system, circulatory system, etc. But you don’t hear about the endocannabinoid system. Unless you happen to be a research scientist or have an interest in medical cannabis you probably would never hear about this body system.

In the 1990’s, while studying how THC (the component of cannabis that has mind altering effects) affects the body, the first cannabinoid receptor in the brain was discovered. A second receptor was later found in the immune system, digestive tract and in major organs and are linked to immune system functions and inflammation. Along with the receptor sites the cannabinoid like chemical, Anandamide was discovered. The Anandamide acts on the two receptor sites to help promote homeostasis (maintaining equilibrium) in the body. The ECS seems to affect all parts of the body including memory, movement, immune system health, sleep, appetite, inflammation, pain and more.

It’s thought that the endocannabinoid system plays some role in pain signaling. As THC and cannabis cannabinoids seem to perform in a similar manner to the body’s own cannabinoid like chemicals they end up affecting this endocannabinoid system and assist in regulating pain transmission or perhaps reducing the pain signals. This is why THC and cannabinoids found in cannabis seem to affect pain. These plant cannabinoids work on the receptor sites found in the body to help reduce pain and inflammation. The research into this system in our body and how external cannabinoids affect it continues and I imagine will continue for quite some time to come before we understand it better.

Does CBD Work For Pain?

Yes CBD (cannabidiol) has shown that it provides analgesic (pain relieving ) properties. There are also other cannabinoids present in cannabis though in smaller amounts. These include:

CBN (cannabinol): this cannabinoid occurs naturally as the cannabis sits around and ages. It can potentially act as an appetite stimulant, pain reliever and sedative.

CBGA (cannabigerolic acid): this is the mother cannabinoid. It is the building block for the formation of THC-A, CBD-A, CBC-A and CBG. Notice how many of these cannabinoids end with A? These are the acidic variation of each of those compounds and through decarboxylation they become activated….THC-A becomes THC, CBD-A becomes CBD, CBC-A becomes CBC. The activated form is the form that is most useful to us.

CBC (cannabichromene): this cannabinoid may act as an anti-inflammatory, anti-depressant, and anti-fungal and may even stimulating brain cell growth during neurogenesis.

These cannabinoids all contribute to the pain relieving properties of cannabis. As time goes on we may begin to see cannabis that contains higher amounts of these cannabinoids as growers produce more strains for those who are specifically looking for pain relief.

Should I use cannabis products with CBD or THC?

When used individually, CBD and THC seem to each affect pain in some way. However, people have reported that using a product that contains a combination of CBD as well as THC actually reduces pain even better when they are combined. The increased effectiveness of using the whole plant versus just individual chemicals is being called the entourage effect. In this case 1 plus 1 does not equal 2. In this case, when using the plant itself or a whole plant extract,  1 plus 1 equals 3!

For those worried about the psychoactive effects of THC studies suggest that CBD counters the effects of THC. Using a product that contains both CBD and THC will have less of a mind altering effect than a product that only contains THC.

What Specific Strains Are Best For Relieving Pain?

As cannabis goes main stream growers are creating new hybrids all the time.  With several family and friends who use cannabis to help with chronic pain I am often updated as to what is available at the local dispensaries. Dispensaries that have a strong connection to a grower, or are also growing their own cannabis, tend to have similar strains in stock on a regular basis. Others that purchase their stock from a variety of locations tend to have short runs (you find it once but it’s not there when you return and you may never see it again).

The names of the strains might also vary as each grower will cross various types of cannabis and then give their new cross a name. I can’t tell you what strains you might find in your own local area so it’s best to check out the dispensary menu to see what the chemical make up of the cannabis that is available to you. When searching out cannabis look for those strains that are high in CBD’s. If the strain contains THC it will often make up a lower percentage than the CBD in that strain. There are also some one to one strains (equal parts CBD and THC). Here’s a listing for flowers available at a local dispensary:

This particular strain is a hybrid that contains 15% CBD and less than 1% THCA (the precursor to THC). THCA is converted to THC when exposed to heat. Using this blend will most likely not cause any type of mind altering effects as the THC level is very low.

Here’s are two other strains that are available locally. They are found in vaporizer cartridges rather than whole flower. CBD Echo is a 3 to 1 blend of CBD to THC and Gorilla Lotus contains a 5 to 1 blend. As they both contain higher levels of THC it is anticipated that it may produce some of the affects that THC is known for when used.

 

Check the dispensaries that are local to you to see what they carry in high CBD strains. Ask about the chemical makeup of any cannabis if it is not listed before you purchase to make sure that it will be beneficial to you. Don’t go by name alone as this does not necessarily indicate what amount of CBD/THC will be found in that particular strain.

Looking to learn more about using cannabis for chronic pain relief? Check out some of these books.

 

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Disclaimer: This is information is not intended as medical advice. The information in this post is intended for those 21 and older who live in a state or country where medical or recreational use of cannabis is legal. If you plan to use a form of cannabis that intoxicates you please do not operate heavy machinery or drive a car. Please follow all local laws concerning cannabis. This website is informational and cannot diagnose or treat illness or disease. Medical marijuana should be used under the direction of a licensed healthcare provider. This site contains advertisements. If you click a link and make a purchase, CannabisNurseMA.com may receive a commission.

 

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My introduction to the use of medical cannabis (medical marijuana), as something being used for something other than getting “high”, was for pain relief. In 2012 voters approved the use of medical cannabis in my home state of Massachusetts. By 2015 the first dispensaries opened. At that time I had thought that the only medical … Read more
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