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Cannabis and Pain Relief 

Around one in five Americans copes with chronic pain(1). Chronic pain can be crippling and debilitating, and the consequences can be long-reaching and devastating. 

If you experience pain, the feeling is all too familiar: the diagnosis can restrict your daily activities, limit your ability to care for yourself or others, disrupt your sleep, prevent you from working, and have a profound impact on your mental health. Relief may feel out of reach, particularly if your pain doesn’t respond to other treatments or if prescription medications give you unpleasant side effects.

When medications, supplements, and alternative practices have failed, patients have described finding both relief and distraction from pain with cannabis. 

What are the different types of pain?

Pain can be caused by several medical conditions or procedures, and each one can exhibit symptoms differently in your body. In addition, pain is a symptom of many approved conditions in medical cannabis programs across the U.S. 

Some common causes of pain include:

  • Injury, including accidents or surgery
  • Pain related to illness such as fibromyalgia
  • Cancer pain
  • Neuropathy
  • Dysfunction of the nervous system such as Multiple Sclerosis

What is chronic pain?

Chronic pain is defined as pain that lasts for longer than three months(2). Chronic pain varies in severity, from mild and tolerant yet persistent, to severe but managed, to intractable and treatment-resistant. Chronic pain is considered intractable once you’ve pursued multiple pain management therapies but experienced little, if any, relief.

How does cannabis impact pain?

Cannabis is believed to impact pain by interacting with the endocannabinoid system (ECS), which is present in your central nervous system, organs, blood vessels, brain, and many other areas of your body from head to toe. When you experience pain, your body produces endocannabinoids which rush to the area of your body experiencing pain and help to calm it down. However, your body only produces so many endocannabinoids; they are used, recycled, and put back out into your body as needed. Phytocannabinoids — the cannabinoids found in plants like cannabis — behave similarly to endocannabinoids, so when you consume cannabis, more pain dampening molecules are introduced to the endocannabinoid system.

Pain works by sending signals from your tissues to your nerves, then to your spinal cord, and finally to your brain. This process is dependent on neurotransmitters that pass the signal from cell to cell. Once the signal is detected as a pain signal, your body activates your sympathetic nervous system — all before your brain realizes what’s going on. Endocannabinoids, which operate independently of your brain and spine, automatically reduce pain signals released between nerve cells, “dampening” how your brain responds to the pain. In response, nerve cells instruct the nerves to stop releasing signals, a process called reverse signalling.

Cannabis helps pain in two important ways: it has a direct impact on the source of the pain, and it can help distract from the pain. Cannabidiol (CBD), found in abundance in cannabis, has been observed to reduce inflammation(4), a major cause of pain. Cannabis can also impact your brain’s perception of pain, providing those who experience round-the-clock pain with some much-needed physical and mental relief.

Medical cannabis products for pain

Cannabis is not necessarily the sole treatment for pain. Rather, the goal is often to incorporate cannabis into your current course of treatment. The right cannabis product, whether vaporized, applied topically, or eaten, may complement many medications, over the counter (OTC) pain relievers, or other alternative treatments like acupuncture or chiropractic care already in play. This way, cannabis can be incorporated into your daily life in a personal manner giving you the best chances of success.

Importantly, cannabis can be consumed with fewer side effects than some common pain medications. Opioids and central nervous system depressants, in particular, put patients at elevated risk for dependence. You can consume cannabis without risking overdose or a laundry list of long-term side effects associated with opiate use. 

While you will likely develop a tolerance to cannabis over time just like you can with opiates, you can safely take a “tolerance break” to help increase your sensitivity to cannabis. Conversely, opiate use may cause permanent brain changes that a tolerance break cannot reverse. These brain changes have been confirmed in animal studies and in small human studies.

Which product is best for pain is determined by how your pain behaves. Identifying where the pain originates, if it was caused by injury, how and when it gets better or worse, and if the pain migrates are just some of the factors taken into account. For example, a topical may help localized pain, while all-over pain might respond better to an edible or capsule, which enter the bloodstream and make their way throughout your body. 

It’s not uncommon to use a combination of cannabis products for pain. You can take a regular daily amount to serve as a “baseline” in your system, while using other forms to help manage pain spikes, called breakthrough pain. For example, you might take a daily capsule as your baseline but carry a vape to help calm breakthrough pain. Inhalation takes effect within a few minutes, and you can quickly assess if you need more to manage breakthrough pain.

As you explore your cannabis product options, it’s important to note that there’s no one “tried and true” product, strain, or cannabinoid ratio guaranteed to work for your pain. A trial and error period is common, and you may change product types or strains several times as you discover what works best.

Alleviating pain with cannabis

Pain is as ubiquitous as it is challenging to treat. Thankfully, cannabis is uniquely positioned to address the reason for pain and to help distract from pain. When incorporated thoughtfully and deliberately into an existing pain management regimen, cannabis can be a powerful — and safe — adjuvant or alternative to alleviating even intractable chronic pain.

If you’re considering cannabis as part of your pain management treatment program, we at Ethos are here to offer guidance and advice. Our associates and pharmacists can help you properly identify your biggest concerns and guide you to the right products to try with ideal cannabinoid and terpene ratios to help you feel better.


Sources

  1. https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm
  2. https://www.healthline.com/health/chronic-pain
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430692/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023045/
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