Medical Marijuana And Chronic Pain

Still, many patients find the cannabis is uniquely superior to prescription analgesics in curbing chronic pain even today. Indeed, chronic pain is the number one symptom for medical marijuana use.

Around 88% of Oregon’s 14,831 medical marijuana patients report using it for “severe pain” (including many who use it for multiple other complaints). In Dr. Mikuriya’s practice, 46% of all patients used medical marijuana for pain while 27% used it for mood disorders and 9% for spasms and convulsions (Gieringer).

Chronic pain treatment

Severe chronic pain is most commonly treated with opioid narcotics like codeine, morphine, oxycodone (in Percocet decoding and OxyContin), and methadone (among other synthetic analgesics). These opiates are notoriously addictive and patients can build up a tolerance to the effects. Furthermore, many patients report states of incapacitation brought on by the stupefying and soporific effects of these drugs. Other, non-addictive synthetic analgesics exist, but they are generally not potent enough to get the job done. Some of these drugs (like acetaminophen, or Tylenol) carry a distinct risk of fatal liver damage in excess dosages.

A growing faction of patients finds that smoking marijuana can completely eliminate the need for potent drugs like opiate narcotics. A good example of this is Bill, who suffered from sciatic pain in the back and legs after spinal fusion surgery: “My doctors prescribed heavy doses of prescription painkillers, including morphine and methadone, after my operation. My legal medicine left me feeling heavily drugged, yet still in pain and unable to lead a tolerable life. l became suicidal. Then one of my doctors suggested I try marijuana. When I tried it, I discovered that it relieved the excruciating, sharp, electric pain I had been experiencing. Although I still experienced some dull, throbbing pain, my level of discomfort was now tolerable, with no ‘drugged’ or negative side effects. Marijuana turned out to be a godsend for me.”

Dr. James B Mattison, a 19th-century authority on cannabis, marijuana often turned out to be an “efficient substitute for the poppy” in the treatment of patients addicted to opium, chloral, or cocaine. “Its power in this regard has sometimes surprised me,” he noted.

Cannabinoids relief pain sensitivity

Recent studies have brought the analgesic action of cannabinoids to the forefront. Research has shown that THC and other cannabinoids actually inhibit acute responses to pain stimuli. Cannabinoids seem to be most effective at relieving enhanced pain sensitivity (or, hyperalgesia) and chronic pain associated with nerve damage and inflammation. Cannabinoids act through the central nervous system by way of the CB1 receptors in the brain and spinal cord, but also peripherally through direct action in the affected body tissues via CB2 and CB1 receptors.

Just like opiates, cannabinoids block pain pathways in the central nervous system only with a different petrochemical signaling system. Thus, cannabis and opium provide differing degrees of relief for different conditions. Some patients can entirely replace opiates with cannabis while others find that they can significantly reduce their dependence on opiates. Some evidence suggests that cannabis and opiates work in tandem to complement or magnify their analgesic properties.

Cannabinoids, unlike opiates, might also act directly on injured tissues by alleviating inflammation around damaged nerves. Cannabis is distinctly effective for neuritis and neuropathy—pain fomented by inflamed or damged nerves. As we have noted, Dr. Abrams’ study found smoked marijuana to be effective in relieving peripheral neuropathy due to HIM. Studies by British company GW Pharmaceuticals have shown marijuana extracts to be effective against neuropathy from diabetes and allodynia (a pain found in MS patients characterized by painful reaction to a normally innocuous stimulus like the brushing of clothing textures). GW Pharmaceuticals also found that Sativex was uniquely effective against cancer pain in patients who weren’t responding to opiates. The very same study did not find any benefits from a pure THC extract lacking the CBD found in Sativex.

For the most part, CBD alone does not appear to be effective for treating pure pain. Teamed with THC, though, it could help alleviate pain indirectly with its sedative action or by relieving muscles spasms.

A few studies have also suggested that cannabinoids might decrease sensitivity to pain that is artificially induced by heat, pinching, chemical irritation, etc. Results, however, have not been consistent. One recent study by Dr. Mark Wallace for the California Center for Medicinal Cannabis Research suggested that smoked marijuana was effective at relieving artificially induced pain, but only at moderate doses (Wallace). As several studies have already shown, excessive doses actually increased pain sensitivity.

Treating chronic pain with marijuana

It would be impossible to list all the painful diseases for which marijuana has provided relief. Many of these diseases are unusual in that they don’t respond to conventional medication at all. Some of these include nail patellar syndrome (genetic underdevelopment of the nails or the kneecaps and other joints); spinal stenosis (squeezing of the spinal column); eosinophilia-myalgia syndrome (EMS—a disease caused by adulterated tryptophan); patellar chondromalacia (softening of the kneecaps, or “runner’s knee”); and pseudohypoparathyroidism (characterized by profuse growth of spurs on the bones). Many of these involve extreme physical pain associated with skeletal disorders or damaged nerves.

Marijuana is one of the preferred drugs among disabled veterans with war injuries and is surreptitiously recommended and provided at some VA clinics for pain that’s otherwise difficult to treat. THC has been shown to be useful for “phantom pain” from amputated limbs; causalgias, or pain felt in limbs whose nerves have been damaged; and neuralgias, often characterized by intesnse pain extending along the nerves (specifically, trigeminai neuralgi—tic douloureux—which causes acute stabbing pain in the jaw).

Cannabis has also been used successfully in the treatment of chronic pain associated with advanced cancer. Research at the University of Iowa Clinical Research Center suggested that oral THC in doses of 5 to 10 mg was almost as effective as 60 mg of codeine for relieving pain for hours in 36 terminal cancer patients (Noyes). With double the dose, 20 mg THC was found to be even more potent than 120 mg of codeine despite the discomfort of the attendant sedated feeling and mental incapacitation. Obviously, the psychoactive effects of THC depend largely on the context in which it is taken, often making it more pleasant for some than for others. Only 1 patient in this study had had no previous exposure to marijuana which made them more sensitive to its adverse psychoactive effects.

The psychoactive effect of cannabis

Some patients have said that the psychoactive effect of cannabis might be an analgesic in and of itself. A final-stage cancer patient named Gordon used cannabis in a regimen of self-treatment for advanced, terminal lymphoma that had spread to his pancreas and bone marrow. He followed a rigorous regimen of diet, exercise, and meditation using only one drug (marijuana). According to Gordon, cannabis did not eliminate the pain but it did help him “learn to move right through it” in a state he described as “vibrating blissfulness.” After repeated experiences, he found that the pain reduced so much that “the ability of the pain to grab my attention was lost.”

Gordon, who grew and cultivated his own marijuana, says that he was able to develop a particular strain that was quite effective in minimizing extreme pain. He also found that it was possible to hybridize different strains of cannabis that could specifically address different kinds of disorders like insomnia, physical and emotional disorders, and more. Unfortunately, the drug police caught wind of Gordon’s labors and destroyed his entire crop.

Thanks for reading. Please leave comments.