CANNABIS FOR PAIN | Science backs the plant’s painkilling reputation

Josh Dickey
May 8, 2018

Everybody hurts sometimes.

Managing chronic pain is just a part of life—something everyone has to endure at one time or another. For many, pain will always be with them.

The good news is that relief has never been easier to find. Cannabis, now legal for adult use in nine states including California, is effective at soothing many types of chronic pain, the rare area of medical marijuana where the research is equally robust and compelling.

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Unlike other indications, where cannabis is considered effective despite a lack of clinical study—like sleep and anxiety, for example—the evidence is strong, abundant and clear. When it comes to pain, cannabis helps.

| RELATED: What is CBD? How the ‘not-high’ cannabinoid can bring pain relief without the buzz |

Harvard University researchers recently led a review of nearly 30 independent studies and trials, many with hundreds of patients. Without equivocation, its authors wrote that cannabis’ efficacy for chronic and neuropathic pain “is supported by high-quality evidence.”

OK, but how does cannabis relieve pain?

While the evidence is clear that cannabis helps with pain—we currently know precious little about exactly how, or what works best. That understanding may come soon as legalization sweeps across the map, stoking interest in and freeing up resources for targeted therapies.

But given that cannabis has been used to alleviate pain for centuries, there are some things we’ve learned by now.

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The two primary active compounds in cannabis—THC, which gets you high, and CBD, which does not—are picked up by receptors in the body’s endocannabinoid system, a network of neurotransmitters that influence and balance myriad functions, including appetite, mood, the immune system and yes—pain sensation.

Pain is merely our nervous system telling the brain that something’s wrong, signals that are influenced by the endocannabinoid network. It’s believed that THC, CBD and terpene compounds in cannabis modulate and regulate those signals in a way that produces an analgesic effect (relief from pain and discomfort all over, similar to over-the-counter pain relievers).

Do some things work better than others?

Very generally speaking, indica strains and products are considered stronger painkillers than sativa. That’s largely based on some broad assumptions about indica, the darker, denser, bushier strain that’s earned itself the mnemonic “in-da-couch” because of its tendency toward more of a “body” high.

| RELATED: What is indica? The secrets of the ancient mountain strain |

But it’s also based on indica’s tendency toward higher levels of THC and CBD.

When separated, the two most abundant cannabinoid compounds do very specific things: THC makes you “high,” euphoric, creative and giddy. CBD has no such psychoactive effect, but is widely known to make people feel more relaxed and less stressed (and has its own promise as a reliever of very specific kinds of pain).

It’s when the two are present together, working in synthesis, that cannabis is considered at peak effectiveness. THC’s high is modulated and mellowed by CBD—the painkilling sweet spot is believed to be. Seek strains and products that are high in both THC and CBD, like these Ritual Nighttime Drops.

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From there, there’s only one thing you can do.

You’ve got to experiment.

Everyone’s metabolism, experience level and types of pain are wildly different. What works for a friend or family member with the same symptoms may not work all that well for you.

Smoking flowers is the best way to ensure you’re getting the full “entourage effect” from all the plant’s cannabinoids and terpenes. Edibles give long-lasting relief, but don’t work the same for everyone. Drops and tinctures are an excellent way to get precise doses and high CBD. And if your pain is local and topical, creams and balms with THC, CBD or both may finally unlock the relief you’ve been seeking.

Speaking of CBD, the “not high” compound has shown lots of promise in treating neurological disorders such as epilepsy, the neuropathic pain associated with multiple sclerosis and in joint and arthritis treatments. If your pain is the result of nerve damage, neuropathy or other nervous-system conditions, try experimenting with CBD, which may give you relief without the buzz.

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Opioids: Breaking the grip.

One of the most heartbreaking aspects of the opioid addiction epidemic is people who were hooked in by the legitimate need for relief from debilitating chronic pain. Cannabis gives us a ray of hope there, too.

A multi-study review published in The Journal of Pain said that cannabis use “was associated with 64% lower opioid use in patients with chronic pain” and “better quality of life.” That’s just one 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.

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But it also speaks 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.

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