As more states legalize cannabis for medical use, there is a growing interest in cannabis as a tool for pain management. Faced with the impacts of the opioid epidemic, a growing elderly population, and the younger generation’s interest in alternative wellness options, it’s a shift our society is ready for. The loosening of cannabis restrictions has primed us to educate ourselves more on what cannabis can do for pain management.
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My experience treating patients as an interventional pain physician, coupled with the latest research findings, affirms cannabis is a versatile tool for managing many forms of pain. Cannabis is already widely accepted for use by cancer patients to relieve the side effects of chemotherapy, and I predict that a customizable approach will help many more patients in years to come.
Why cannabis for pain management?
Chronic pain affects approximately 50 million adults in the U.S. and 1 in 5 adults globally. Cannabis has the potential to aid in treatments without the severe side effects of long-time opioid use.
Research shows that cannabis is safer than opioids, which result in over 70,000 deaths annually in the U.S. and carry a 20 percent addiction rate. Cannabis has an addiction rate closer to six to seven percent. Additionally, one study even shows that medical cannabis can reduce opioid use by up to 64 percent among chronic pain patients.
The key to cannabis’ effectiveness is all in the science of the plant. Cannabis contains over 100 cannabinoids, with the most well-known being tetrahydrocannabinol (THC) and cannabidiol (CBD). Cannabis enthusiasts likely know these well. However, beginners are often surprised to learn the role that cannabinoids play alongside a complex network in the body known as the endocannabinoid system (ECS). The ECS plays an important role in regulating various physiological processes, including pain sensation, using receptors and signaling molecules that interact with cannabinoids found in the plant.
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The synergy between THC, CBD, and many other minor cannabinoids is known as the “entourage effect,” believed to enhance the overall pain-relieving benefits of cannabis. This combination allows for the potential to reduce pain while minimizing some of the undesirable psychoactive effects associated with high doses of THC.
Early on in my career, I was surprised to learn that our bodies have a whole system in place ready to interact with cannabis, and yet this plant was not a top form of pain management. It was then that I realized the strong need for studies, research, and education on the ECS, and I committed to work to help my patients learn more about its potential.
Education will lead way to more customizable treatments
A major benefit of cannabis treatments for pain management is that they can be personalized for each patient. As an interventional pain physician, I recommend specific terpenes for tailored approaches to pain management. There are different balances of THC, CBD, and other compounds that can address specific concerns without creating unwanted side effects. From inhalation to edibles, sublingual tinctures, and oils, there are many forms of cannabis ideal for pain management, depending on a patient’s conditions and preferences.
Research has also shown that specific types of pain affect men and women differently. The more we uncover, the more we can use cannabis as a tool to tailor pain management for each person. For example, a study has shown that for women experiencing conditions like fibromyalgia (FBM) and migraines, which are often associated with endocannabinoid system (ECS) deficiency, CBD’s ability to inhibit fatty acid amide hydrolase (FAAH) plays a crucial role.
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FAAH is an enzyme responsible for breaking down anandamide, one of the body’s key endocannabinoids involved in pain regulation. By inhibiting FAAH, CBD helps increase anandamide levels, enhancing the body’s natural pain-relieving and anti-inflammatory mechanisms. Pre-clinical studies on animals have shown promising evidence that this action can be particularly beneficial for managing widespread pain in fibromyalgia and the intense, throbbing pain of migraines.
And though more studies are needed for validation, men with conditions like cluster headaches or gout may benefit from cannabis strains with a balanced THC-to-CBD ratio, enhanced by beta-caryophyllene and humulene, which target inflammation and pain at the receptor level without significant sedation.
Unlike opioids, cannabis may also address the emotional impacts of living with pain. Those with chronic pain are also more likely to have depression, anxiety, and/or insomnia. Many patients find medical cannabis offers relief from both physical and emotional ailments.
The nature of pain itself continues to be studied. As we uncover more about the source of pain, whether from nerve damage, emotional trauma, or physical injury, studies are being conducted on how cannabis can treat each. This will lead to even more specific treatments and support for individual patients.
The future of cannabis for pain management
It takes outreach to patients to make them comfortable with approaching cannabis as a pain management treatment. Decades-long propaganda against the plant and a constantly shifting regulatory landscape keep many would-be patients from seeking cannabis as treatment.
When cannabis becomes better understood by the public, as well as more accepted in pop culture through sports and entertainment, people become more open to using it as a form of treatment. According to one retired player, many NBA players use cannabis for various purposes. The NFL has also partnered with two universities to study cannabinoids for traumatic brain injuries. Much like the regulatory changes taking place in states and communities around the country, professional sports leagues are also beginning to explore cannabis as a potential treatment for athletes, something I’m hopeful will continue to evolve.
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The potential rescheduling of cannabis at the federal level could also mark a turning point in pain management, opening doors for further research and broader access to tailored cannabis treatments. If cannabis moves away from its Schedule I status, the stigma and legal barriers hindering its use in clinical settings may diminish, allowing for a more patient-centered approach.
Cannabis is also emerging as a popular option for managing anxiety, even among recreational users who seek its calming effects. The cannabinoids THC and CBD interact with the body’s endocannabinoid system, potentially reducing anxiety and stress in small, controlled doses. As societal attitudes shift toward greater acceptance of cannabis use, both medically and recreationally, it’s crucial to educate the public on responsible consumption and the nuanced effects that different strains can have on anxiety symptoms.
I always say my favorite pain management product is the one that helps the patient. The future of cannabis for pain management is one where the patient’s needs are listened to and treated with the utmost precision.
*This article was submitted by a guest contributor. The author is solely responsible for the content.