Sep 17, 2016 9:45 AM

Study Review: Cannabis Can Help With Chronic Pain

Millions of Americans live with chronic pain. If to be precise, nearly 100 million people in the United States are affected by chronic pain, according to a 2012 report by the National Center for Complementary and Integrative Health.

Chronic pain is not the same as the pain you feel from an injury. It is an oppressive, acute ache in joints, bones, or muscles that remains active for months or even years. It can disrupt your mood, relationship, work, and, in perspective, your overall well-being. A neurological surgeon and pain expert at the University of Washington, Dr. John D. Loeser, describes pain as a very complex phenomenon that involves biological, psychological, sociological, and environmental factors.

What Is Chronic Pain?

Pain is considered chronic if it lasts more than six months. An alternative definition of chronic pain is “pain that extends beyond the expected period of healing.”

Chronic pain often, though not always, begins with an injury, tissue damage, or other conditions like fibromyalgia, but other factors are also contributing to it: the relentless nature of chronic pain suggests that the emotional and environmental effects add to the intensity and tenacity of the pain.

Researchers tend to divide the pain experience into three dimensions: the sensory-discriminative, affective-motivational, and cognitive-evaluative. While there is a balance between each of these dimensions in acute pain, which allows physicians to determine the location and evaluate a potential threat, chronic pain brings chaos.

Oftentimes, people with acute pain think their system will take care of everything. So when the pain lasts longer than they expect or even intensifies, they get irritable and angry. Tension growths, leading to more pain.

It can also play conversely: mental processes alert sensory phenomena, including pain. Athletes can continue to play with debilitating injuries, and minor trauma can lead to paralyzing ache. Sometimes, chronic pain may originate in the absence of any past injury or infection—there are at least twelve disorders, including atypical facial pain and phantom limb pain, where pain may occur in the absence of tissue damage. The affective-motivational dimension becomes dominant, which leads to psychological consequences.

Drug Treatments for Chronic Pain

Pain is probably the most common symptomatic reason to seek medical consultation.

Unfortunately, most treatment options prescribed for treating chronic pain are only nominally effective. Prescription painkillers can provide considerable relief for some people but are ineffective at relieving neuropathic pain. The worst thing is that they cause addiction: according to a recent Kaiser Family Foundation survey, one in five Americans say that they have a family member who has been addicted to prescription painkillers.

Narcotics (doctors prefer to call them “opioids”) are the mainstay of treating chronic pain: codeine, oxycodone, morphine, hydrocodone. Studies show that oxycodone and hydrocodone are the most abused prescription drugs in the United States. Furthermore, long-term use of most conventional pain relievers may cause strokes, erectile dysfunction, hepatoxicity, and heart attacks.

Pain medication ignores the psychological and social aspects of pain, that is why some people try an alternative treatment for pain management: yoga, stretching, meditation, acupuncture, physical therapy, and medical marijuana.

In 2014, nearly 28,000 Americans died from unintentional overdosing on prescription opioids. So it is no wonder that more and more people who suffer from chronic pain are turning to cannabis as an alternative treatment.

Cannabis Is Effective

Chronic pain is one of the conditions for which medical marijuana use is allowed in 25 states and D.C.

Numerous studies indicate the effectiveness of the use of marijuana for chronic pain management. Thus, a 2015 Harvard-led clinical review of 28 studies examining the efficacy of cannabinoids to treat various kinds of pain, concludes that “use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence.” Notably, three of the studies investigated smoking cannabis. According to a 2007 randomized placebo-controlled trial, smoking marijuana reduced neuropathy in patients with HIV by more than one-third compared to placebo. The authors concluded that “smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated sensory neuropathy.”

Authors of a 2007 trial at the University of California reported a significant reduction of neuropathic pain of diverse causes in the patients who could not achieve pain relief from standard pain therapies.

Not only smoking but also vaporizing marijuana may mitigate pain. A Canadian systematic review of randomized controlled trial on the effect of cannabinoids in the treatment of chronic non-cancer pain (including neuropathic pain, fibromyalgia, rheumatoid arthritis, and mixed chronic pain) concluded that fifteen of the eighteen trials demonstrated “a significant analgesic effect of cannabinoid as compared with placebo and several reported significant improvements in sleep.” Authors also pointed at the absence of serious side effects.

Cannabis Is Safe

The safety of marijuana therapy has been demonstrated by many researchers from different countries. For example, a 2015 Canadian systematic review described cannabinoids as a safe, reasonable treatment option for chronic non-cancer pain relief. British scientists were studying the efficacy, safety, and tolerability of the THC:CBD extract and THC compound extract in patients with cancer-related pain not fully relieved by strong opioids. They found cannabis to be effective and relatively safe pointing at the fact that “most drug-related adverse events were mild or moderate in severity.”

Cannabis vs. Opioids

Many people turn to narcotics as a cheap, easily accessible, and potent alternative. At the same time, scientists and health care officials sound the alarm: the United States has been hit hard by the opioid epidemic. Since 1999, the number of opioid overdose deaths has quadrupled. Every day, seventy-eight Americans die from an overdose on prescription opioid pain relievers and heroin, according to the Centers for Disease Control and Prevention.

However, an increasing number of studies provide evidence that cannabis may be part of the solution. Furthermore, it can play a significant role in combating the nation's painkiller crisis. According to a 2014 study published in the Journal of the American Medical Association (JAMA), states with medical cannabis laws had a nearly 25 percent lower annual opioid overdose mortality rate compared with states without marijuana laws.

Researchers at the University of Michigan also decided to study the issue. They found that cannabis could decrease the side effects of other medications, reduce the use of opioids by nearly 64 percent, and significantly improve the quality of life in patients suffering from chronic pain.

Many doctors urge officials to add opioid addiction to the list of conditions which could be treated with medical marijuana, and pain experts advise physicians to recommend cannabis therapy instead of opioids. Past February, Massachusetts Senator Elizabeth Warren even sent a letter to the director of the U.S. Centers fro Disease Control and Prevention asking to look into the effectiveness of the drug as an alternative to opioids for pain management in states where marijuana is legal.

Fortunately, medical marijuana uses become more widespread among patients seeking chronic pain relief.

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