Pain is the most common symptom that medical cannabis is used to address, and it is also the oldest use of the plant. Our ancestors relied on this medicinal herb to alleviate acute pain, such as toothaches, labor pains, and even during childbirth. There is evidence suggesting that some painful conditions, like migraines, may be triggered by an endocannabinoid deficiency, which is why cannabis can be so helpful. But what about patients suffering from chronic pain? Can cannabis be used in those cases too?
The Use of Cannabinoids
The cannabis plant produces various chemical compounds such as terpenes, flavonoids, esters, and cannabinoids, which originally serve as defense and protection mechanisms. In our society, where knowledge and acceptance of cannabis are steadily increasing, the cannabinoids THC and CBD are currently the most well-known. Since the cannabis plant naturally produces these cannabinoids, they are called phytocannabinoids.
The human body has an endocannabinoid system and also produces cannabinoids, similar to the hemp plant. These cannabinoids are called endocannabinoids because "endo" means "within the body." The endocannabinoid system permeates the entire human body and has 15 different receptor types. These receptors serve as binding sites for both endo- and phytocannabinoids, initiating various processes, such as cell production. Currently, only two receptors, CB1 and CB2, are well-known.
When the endocannabinoid system functions optimally, we are healthy and feel well. This is why this plant has such a significant impact on us.
The Entourage Effect
The other phytochemicals mentioned above also play an important role in the effects of the cannabis plant. Research is currently focused on understanding the significance of terpenes in cannabis medicine because they act similarly to cannabinoids and could be of great importance. Both the number and concentration of these substances are crucial for their therapeutic effects. They can enhance or diminish each other's effects, which is known as the entourage effect.
For example, a high dose of THC can cause nausea in some consumers. However, the cannabinoid CBD can mitigate this nausea while amplifying other positive effects of THC.
Pain Relief with Cannabis
The human body produces endocannabinoids in nerve cells and other cell types as needed, particularly in response to strong pain signals caused by injuries, for example. Some phytocannabinoids are known for their pain-relieving effects. They bind to the CB1 receptor, blocking the transmission of pain signals and activating the production of the hormone endorphin, which also acts as a natural painkiller. Additionally, the targeted intake of the terpene myrcene increases the production of endorphins in the body.
Cannabis-based medicines are proven to alleviate pain through various mechanisms.
Treating Chronic Pain
When is pain considered chronic?
In medicine, pain is considered chronic when it persists for more than three months without resolving on its own. This type of pain often develops into a distinct condition that can significantly burden affected patients and requires treatment.
There are already some pain medications available for treating chronic pain, but they can cause severe, long-term side effects, damage organs, and even lead to addiction. Cannabis-based medicines have minimal side effects and addictive potential, especially when they contain a high proportion of cannabidiol (CBD), which has been shown not to be addictive.
Cannabis can be used for pain relief and reduction in various forms, even over a long period. There are reports from pain patients suffering from conditions like multiple sclerosis who have been able to replace strong medications like morphine with cannabis-based medicine, thereby reclaiming a significant portion of their quality of life.
The State of Research
Several studies clearly demonstrate that cannabis-based medication can effectively reduce pain in various conditions and chronic pain. However, further long-term studies and research are necessary to provide targeted and unequivocal recommendations for the use of cannabis.
Positive findings from studies also indicate that cannabis consumption not only reduces pain but also improves sleep quality and overall well-being in patients.
Cannabis strains with high levels of THC and CBD can be helpful for persistent and chronic pain syndromes. Strains that produce significant amounts of myrcene and linalool, in combination with THC, provide additional pain relief. For example, Afghan contains high levels of myrcene and THC, resulting in pronounced relaxation and reduced pain. Trainwreck is a suitable strain for daytime use in pain therapy as it alleviates pain while providing a stimulating effect.
Methods of Administration
Cannabis can be consumed orally or sublingually in the form of capsules, drops, oil, or spray (Sativex®). There is also the option of smoking or vaporizing the flowers, with vaporization being preferable as it is less harmful to the body than smoking.
The advantage is that the effects set in within minutes when vaporizing. With oral or sublingual administration, it may take some time for the patient to feel the effects. Finally, cannabis can also be processed into cookies or consumed as tea, although the onset of effects in these cases usually takes around 30-45 minutes.
The optimal dosage for pain therapy depends on various factors and varies for each patient. Therefore, a slow and controlled titration phase, under the guidance of a treating physician, is important. Generally, for chronic pain, it is recommended to take a low but consistent dose to maintain the effectiveness of the active compounds.
The bottom line
Medical cannabis proves to be a promising option for treating chronic pain. The cannabinoids THC and CBD, along with other phytochemicals, provide pain relief and can improve well-being. The endocannabinoid system plays a crucial role in pain reduction. Studies confirm the effectiveness of cannabis-based medicine, although further research is needed. Suitable strains with high THC and CBD content can be helpful, and various administration methods are available. The optimal dosage should be individually adjusted and monitored under medical supervision.
Author: Mila Grün for Weed!
Image: Francisco Gonzalez on Unsplash
- Michael Backes, Cannabis als Medizin, October 2021, 2nd edition, Kopp Verlag
- Tammy Sweet, Ganzheitliche Heilung mit Cannabis, 2021, 1st edition, Herba Press Verlag
- Study sources: https://pubmed.ncbi.nlm.nih.gov/24420962/; https://pubmed.ncbi.nlm.nih.gov/19896326/
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