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Cannabis vs Opioids: Solution to Chronic Pain?

Chronic pain can be a n extremely debilitating condition. For many who suffer from it on a daily or near daily basis, the condition is very oppressive. It affects other parts of their lives, impacting their mood, health and overall well-being. Unfortunately many treatment options are only nominally effective. What worse is that commonly prescribed drugs like opioids are highly addictive and toxic. The CDC has shown that 28,000 people died from an opioid overdose in 2014. This is more than any other year in history to date. It’s no surprise that a growing number of the estimated one in five Americans who suffer from chronic pain are turning to cannabis as an alternative.

While many people believe cannabis to be an effective treatment, what does science say? Is it really more effective and safer than other drugs? Cannabis and cannabinoid-based formulations’ effects on chronic pain is one of the best studied field of cannabis research. However, the causes for chronic pain are diverse and it can either be nociceptive or neuropathic.  Tissue damage or inflammation is the cause of Nociceptive pain.  Neuropathic pain is caused by nervous system damage or malfunction.

Everyone’s biology is unique and will respond differently to cannabis depending on a number of variables. These variables include the type of chronic pain of the patient, dosage, strain and consumption method.

Effectiveness of Cannabis for Chronic Pain Relief

In a comprehensive, Harvard-led systematic review of 28 studies examining the efficacy of exo-cannabinoids to treat various pain and medical issues, the author concluded, “Use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high quality evidence.”

Of the studies reviewed:

  • 6/6 general chronic pain studies found a significant improvement in symptoms and;
  • 5/5 neuropathic pain studies found a significant improvement in symptoms.

Notably, while most of the studies were limited to synthetic preparations of cannabinoids, 3 of 5 neuropathic pain studies investigated “smoked” cannabis, while two examined an oral spray administration.

Dr. Donald Abrams, a professor and Chief of Hematology/Oncology at San Francisco General Hospital, supports cannabis to treat chronic pain, suggesting the following:

“Given the safety profile of cannabis compared to opioids, cannabis appears to be far safer. However, if a patient is already using opioids, I would urge them not to make any drastic changes to their treatment protocol without close supervision by their physician.”

Both THC and CBD in cannabis are known to elicit analgesic effects, especially when used together due to their congruent chemical synergies.

Cannabis vs Opioids

North America is facing the brunt of the opioid epidemic. Prescriptions have increase by a huge 400% since 1999, and following this trend is a shocking increase in fatal overdoses. Every day, 40 people now die from prescription narcotic overdoses on a daily basis. Many also move on to heroin because it is cheaper, easier to find and way more potent.

Could cannabis be part of the solution? Quite possible. An increasing number of studies provide evidence that many patients can use cannabis instead of opioids to treat their pain, or they can significantly reduce reduce their reliance on opioids.

A University of Michigan March 2016 study published in the Journal of Pain provides some compelling data. They found that cannabis:

  • Decreased side effects from other medications.
  • Improved quality of life.
  • Reduced use of opioids (on average) by 64%.

“We are learning that the higher dose of opiods people are taking, the higher the risk of death from overdose,” said Dr. Daniel Clauw, one of the study’s researchers and a professor of pain management anesthesiology at the University of of Michigan. He also said that the magnitude of reduction in their study is significant enough to affect a person’s risk of accidental death from overdose.

Cannabis Might Be A Little Trial and Error

The chemical composition of the strain you choose and how you consume it will affect the outcome. It might take a bit of sampling before you find the most effective cannabis strain, dose, and consumption method for your particular problem. Most importantly, if you are currently using opiods, exercise extreme caution. You should only change your treatment protocol under medical supervision.

You might want to look at the advice of Dr. Michael Hart, head physician at Marijuana for Trauma in Canada: “When considering cannabis to treat chronic pain, the adage ‘less is more’ rings true. Patients seem to find more relief in indica strains which are higher in THC than most sativa or hybrid strains. What we’ve found is that these strains can be highly effective in low to moderate doses, but could actually make pain worse in higher doses. So it’s important to start low, and titrate up as appropriate.”