Chronic pain is associated with hundreds of different medical conditions. It is estimated to affect over 20 million people in the United States. Some conditions that cause neuropathy are Neck and Back nerve impingement (causing chronic pain and sometimes numbness and or weakness), multiple sclerosis, Parkinson’s Disease, HIV/AIDS, cancer (chemotherapy and radiation drugs), diabetes, alcoholism, autoimmune diseases, kidney and liver diseases, thyroid conditions, hepatitis, bone marrow disorders, trauma from an injury, amputations, or other nerve damage. Symptoms of neuropathic pain include numbness or tingling in the hands or feet which may spread to the legs and arms, sensitivity to touch, or pain with any activity, such as standing or putting very lightweight on the feet. Neuropathic pain is usually described as stabbing, burning, or tingling pain. Neuropathy can also cause muscle weakness, loss of muscle control, balance deficits, sensitivity to heat or cold, dizziness, bowel and bladder problems, or changes in body temperature. Pain may be constant or come on spontaneously without a triggering event. Neuropathy can be brought on by things that are normally not painful, such as gentle touch, cold, or light pressure. It can cause emotional problems, trouble sleeping, and a decrease in overall quality of life. Numerous studies demonstrate medical cannabis relieves neuropathic pain. Medical cannabis is generally safer for long-term use when compared to pharmaceuticals. It also has the ability to relieve symptoms that accompany neuropathic pain, such as sleep disturbances, fatigue, anxiety, and depression. Medical marijuana is a better alternative to pain medications because it can be used without intoxication, doesn’t have harsh side effects, and relieves multiple symptoms, going beyond pain to improve sleep and overall mood as well. 1:1 THC to CBD ratios were proven effective in studies of patients with chronic neuropathic pain and are usually non-intoxicating. 10:1 or higher ratios of CBD to THC will be completely non-intoxicating for all users.
Relieve Chronic Pain with Medical Marijuana
Cannabis has been employed to treat pain based on its action on both CB1 and CB2 receptors. CB receptor agonists have been revealed to cause antinociceptive and antihyperalgesic effects by regulating neuronal and non–nervous system inflammatory activity. One theory proposes that activation of CB1 receptors in mast cells elevates cyclic adenosine monophosphate and suppresses degranulation. Analgesia may also result from CB1 receptor activation, causing negative modulation of the P2X3 receptor in primary afferent neurons. Activation of CB2 receptors can hinder the release of proinflammatory factors, causing suppression of nerve growth factor-induced mast-cell degranulation and neutrophil accumulation.
A growing body of clinical research and a history of anecdotal evidence supports the use of cannabis for the relief of some types of chronic pain, including neuropathic pain, and spasticity associated with multiple sclerosis. In a recent comprehensive review of current data on the health effects of cannabis and cannabinoids, the National Academies of Sciences determined that adult patients with chronic pain who were treated with cannabis/cannabinoids were more likely to experience a clinically noteworthy reduction in pain symptoms. They rated these effects as “modest.” Studies also imply some efficacy for cancer-related pain, migraines, fibromyalgia, and other pain conditions. It has been suggested that these compounds may be valuable in other conditions, including rheumatoid arthritis, osteoarthritis, and various other types of acute and chronic musculoskeletal pain. However, how different cannabis species, routes of administration, and doses differ in their effect is less clear, and more research is required.
Chronic pain relief is by far the most common condition cited by patients using medicinal marijuana. Studies and observational reports have demonstrated that more than 80% of patients enrolled in clinical trials and/or with a medical cannabis card indicate “severe pain” as the reason for use. In addition, evidence proposes that some individuals with chronic pain are substituting the use of opiates with cannabis. Data from a survey directed by a Michigan medical cannabis dispensary claimed that the use of medical cannabis was associated with a 64% decrease in the use of opioids. In addition, a recent analysis of prescription data from Medicare Part D enrollees in states with medical access to cannabis suggested a substantial reduction in prescriptions for conventional pain medications, principally opioids.
Clinical Study Results
A number of research studies examined the efficacy of medical cannabis on treating chronic pain and other conditions. For example, the findings from a 2019 study published in the Journal of Psychoactive Drugs, which evaluated data from 1,000 individuals taking legalized cannabis in one state, found that among the 65% of individuals taking cannabis for pain, 80% found it was very or tremendously helpful. This led to 82% of these individuals being able to reduce or halt, taking OTC pain medications and 88% being able to halt taking opioids.
In addition, results reported at the American Academy of Neurology 2019 Annual Meeting revealed that in a preliminary study, investigators at the Dent Neurologic Institute in Buffalo, New York, found that cannabis provided elderly patients with relief from chronic pain, sleep disorders, and anxiety related to diseases such as amyotrophic lateral sclerosis, Parkinson disease, neuropathy, spinal cord damage, and multiple sclerosis. Their findings show that medical cannabis is well tolerated in people aged 75 years and older and may improve symptoms such as chronic pain and anxiety.
Finally, some evidence suggests cannabinoids may diminish opioid requirements for analgesia, although this finding is not conclusive. In a systematic review, Nielsen et al evaluated the effect of cannabinoids to reduce opioid requirements for analgesia and found some lower quality studies suggesting a reduction in opioid requirements during coadministration with cannabinoids. Higher quality studies, however, failed to confirm an opioid-sparing effect.