According to the Canadian Pain Society, pain is the number one reason people go to the doctor. Pain is also responsible for up to 78% of emergency department visits in the country. Unbelievably, pain research only accounts for less than 1% of funding from Canadian Institutes of Health and Research, a woefully low number to combat such a common problem.
Usually opioids or other drugs are prescribed for pain. But these pills come with a host of dangerous side effects and sometimes aren’t even effective at managing pain in the first place. People are now re-discovering another pain reliever—cannabis. Pain sufferers have been using cannabis for centuries, and now pharmaceutical companies are taking notice and using marijuana derivatives to produce pain medications that seem to actually work.
Pain Relief Treatments Inadequate, so People Turn to Cannabis
The usual treatments of analgesics for chronic pain—from opiates to antidepressants and anticonvulsants—are no longer adequate, especially in intractable cases such as cancer-associated pain and neuropathic pain, which is caused by damaged nerves.
In a 2011-2012 study by Ameritox, an American company that performs urine drug tests, urine samples were collected from patients who were prescribed hydrocodone, one of the most frequently prescribed opioids. Of the urine samples that tested positive for marijuana, 36.5% showed no traces of the prescribed hydrocodone. “The data strongly suggests that marijuana use is associated with an increased prescription non-drug adherence," said Harry Leider, MD, Ameritox’s chief medical officer. What this means is that people who used cannabis didn’t have to take the hydrocodone because the marijuana provided enough pain relief on its own.
How Cannabis Helps Relieve Pain
To equip physicians with better pain management tools, researchers are taking another look at cannabis, which has been used for pain for more than 2,000 years. Research discovered that the main cannabinoids in marijuana, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), are similarly structured to the body's own endocannabinoids (neurotransmitters that produce pain relief). This allows THC and CBD to bind to cannabinoid receptors in the body and elicit analgesia. The non-psychoactive CBD also helps by reducing nausea, decreasing anxiety, suppressing seizures, and inhibiting the synthesis of pro-inflammatory proteins, making marijuana an effective anti-inflammatory agent as well.
Cannabinoid receptors are located in different areas of the body, but when it comes to neuropathic pain, those situated in the rostral ventromedial medulla (RVM) part of the brain play possibly the most critical role. Scientists in Italy were able to confirm that two non-psychoactive cannabinoids—CBD and cannabichromene (CBC)—in marijuana successfully targeted the RVM in rat models. The findings confirm the viability of marijuana in treating neuropathic pain induced by cancer, HIV, alcoholism, diabetes, shingles and amputation, to name a few.
Cannabis-Based Drugs Are on the Right Track
Sativex is a cannabis-derived drug that contains equal parts THC and CBD, and is currently approved in 30 countries to treat neuropathic pain in MS patients. Its safety and efficacy are demonstrated in several clinical trials, including for rheumatoid arthritis.
For those who suffer from pain, cannabis and cannabis-based pharmaceuticals could not only improve their quality of life, but also give them alternatives to highly addictive opioids.
Photo credit: Jonathan Perez