Cannabis for Pain: What does the science say?

Everybody hurts sometimes.

But for some, managing chronic pain is just a part of life—the pain will always be with them. The good news? We humans have been using cannabis for pain for thousands of years. What’s different now is that a growing body of evidence supports the use of pot for pain.

Since it’s not just one “active ingredient” but many dozens of them—like THC, CBD, terpenes, and many other compounds—cannabis can relieve pain in several ways, including:

• Reducing the severity of pain signals
• Acting as anti-inflammatory agents
• Modulating the release of pain-signalling neurotransmitters

…and more. Since different varieties of cannabis contain different compounds, using specific cannabis strains for pain may offer extra-targeted relief for those who need it most.

OK, but how does cannabis relieve pain?

Curiosity about pain and THC isn’t new, as we’ve been leaning on the cannabis plant for a long, long time. However, recent research is finally backing up what people in history have already known about cannabis and its potential to relieve pain.

The two primary active cannabinoids found in cannabis—THC, which gets you high, and CBD, which does not—are picked up by receptors in the body’s endocannabinoid system (ECS), a network that influences and balances many bodily functions, including appetite, mood, the immune system, and the perception of pain.

Pain is merely the nervous system’s way of telling the brain that something’s wrong. These signals are influenced and modulated by THC, CBD, and certain terpenes in cannabis, which interact with two different types of receptor cells: CB1 and CB2.

THC interacts with CB1 cells, imparting its distinctive euphoria while reducing pain perception. Conversely, CBD interacts with CB2 cells to inhibit the production of specific proinflammatory proteins, thus helping to reduce swelling and pain.

Do some cannabis strains for pain work better than others?

Generally speaking, indica strains and products are considered stronger painkillers than sativas. That’s largely based on some broad assumptions about indicas—the darker, denser, bushier strains that can produce “couch-lock” due to their tendency to produce a relaxed body high for indica fans.

Many believe that indicas have naturally higher levels of THC because of their physical effects, but those beliefs can be misleading. Believe it or not, sativa strains—associated with more energizing effects—are generally higher in THC than indicas. So, it may be more helpful to look at the specific compounds in cannabis strains as opposed to the general terms like sativa and indica, which are useful but may have less clinical value.

When separated, the two most abundant cannabinoid compounds do very specific things: THC can create feelings of euphoria, creativity, and giddiness, while CBD has no such intoxicating effects. However, CBD is widely known to make some people feel more relaxed and less stressed.

Many researchers suggest that when the two cannabinoids are consumed together and working in synergy, cannabis may be most effective for combatting pain. As some studies have found, THC and CBD work especially well in concert. Though previous studies have suggested that CBD might mitigate some of the potential adverse effects of high doses of THC—including paranoia and anxiety—the latest research suggests otherwise.

The takeaway? If you’re using cannabis for pain, seek strains and products that are high in both THC and CBD.

You’ve got to experiment.

Everyone’s metabolism, cannabis experience level, and types of pain can be vastly different. Types of strains and products that work for a friend or family member with similar symptoms may not work for you. Fortunately, there are many options to choose from:

• According to some sources, smoking flower is the best way to ensure you’re getting the full “entourage effect” from all the plant’s cannabinoids and terpenes.
• Edibles can give long-lasting relief but don’t work the same for everyone.
• Drops and tinctures may be an excellent way to get precise doses and high amounts of CBD.
• Creams and balms that contain THC, CBD, or, ideally, both may offer localized pain relief for your muscles or skin irritations.

What about cannabis for nerve pain? CBD has shown lots of promise in treating neurological disorders such as epilepsy, the neuropathic pain associated with multiple sclerosis, and joint and arthritis treatments. If your pain is the result of nerve damage, neuropathy, or other nervous system conditions, consider experimenting with CBD to see what works for you.

Cannabis for chronic pain: breaking the grip of opioids.

Deaths from opioids are roughly six times higher than they were in 1999, and due to their highly addictive properties, many have sought other ways to reduce pain without the use of these medications. A much-quoted multi-study review published in The Journal of Pain in 2016 said that cannabis use “was associated with 64% lower opioid use in patients with chronic pain” and “better quality of life.” Since then, further research only bolsters the point.

These clinical papers are just two of many sources building toward the notion of cannabis as an opioid “exit” drug—or better yet, one that may keep people from getting hooked in the first place. They also speak to cannabis’ power as a painkiller, something that not only dates back centuries but is backed by multiple modern scientific trials, studies, and reviews—and plenty more of that is on the way.