Pot for Pain?
Pain comes in all sorts, and each of us has experienced it in some way or another. Whether it’s the pain of a headache, a broken bone from a fall, we all have pain receptors. What happens when it isn’t temporary? When your nerve endings have permanent pain, and it tingles and hurts chronically? Pain then becomes a long-term issue, chronic, and it can have a significant impact on quality of life. What does a person do when traditional medications don’t cut it, and increasing tolerance to medications, such as opioids, with other side effects as an issue? With the approaching legalization of cannabis becoming more and more it has many wondering if it is a good option for pain relief.
A Quick look at Neuropathic Pain:
- Neuropathy is the damage to the sensory, motor or automatic nerves that occurs from an underlying cause such as diabetes, accident, spinal cord or nerve damage.
- It’s a complex and chronic condition that affects nearly 20 million people in the United States. That’s 20 million people seeking relief.
- Neuropathic pain accounts for about one in five cases of chronic pain.
- Neuropathic pain is notoriously difficult to treat. Medications that are normally prescribed for other types of pain (e.g., non-steroidal anti-inflammatories or opioids) are most often times ineffective.
So, studies suggest that cannabis may be a good treatment option to relieve chronic neuropathic pain but does the evidence stand up to the hype, or are the pain-relieving properties smoke and mirrors?
What does the research say?
THC and CBD are the two chemicals found in marijuana that are thought to contribute have the ability to relieve pain. THC alters pain perception by reducing anxiety and stress, while CBD has anti-inflammatory benefits that lessen pain. Cannabis-based medications come in several forms, so for the naysayers on smoking being risky, it can also be ingested in foods, taken as a supplement, and also available in tincture options.
A recent systematic review found that compared to a placebo, cannabis-based medications have the ability to provide moderate to substantial pain relief, reduce pain intensity, help with sleep problems, and also mental and psychological distress such as anxiety and PTSD. Unfortunately, these benefits also come associated with side effects including sedation, confusion, and psychosis.
The catch here is for some people, these side effects may be severe enough to outweigh cannabis’s pain-relieving benefits, yet how the drug is used also effects its side effects.
Where does this leave us?
Overall the fact is…the quality of the research around cannabis for neuropathic pain relief is low. That is not to say that neuropathic pain sufferers should disregard cannabis as a treatment option – but as with any treatment, it may work for some, but not for others.
The bottom line ___________
- More high-quality research is needed to confirm its benefits.
- Many people experience neuropathic pain, which becomes more common as we age.
- Cannabis-based medications may relieve pain in some people, but side effects such as sedation, confusion, and psychosis can cause the risk to outweigh the benefit.
- Current evidence is of low quality, so while promising, more high-quality research is needed to completely determine the effectiveness of cannabis-based medications for the treatment of neuropathic pain.
Hill, K. P., Palastro, M. D., Johnson, B., & Ditre, J. W. (2017). Cannabis and Pain: A Clinical Review. Cannabis and cannabinoid research, 2(1), 96–104. doi:10.1089/can.2017.0017
Modesto-Lowe, V., Bojka, R., & Alvarado, C. (2018). Cannabis for peripheral neuropathy: The good, the bad, and the unknown. Cleveland Clinic Journal of Medicine, 85(12), 943–949. doi: 10.3949/ccjm.85a.17115
Wallace, M. S., Marcotte, T. D., Umlauf, A., Gouaux, B., & Atkinson, J. H. (2015). Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. The journal of pain : official journal of the American Pain Society, 16(7), 616–627. doi:10.1016/j.jpain.2015.03.008