Chronic pain, also known as persistent pain, is as debilitating as the name suggest. Categorised as pain that is consistent over a duration of three or more months, chronic pain effects as many as one in five Australians.  Unfortunately for many, the pain is often caused from an injury that technically has healed and, in many circumstances, the original cause of the pain cannot even be identified. As such, the mental pain of the vague diagnosis can also have a negative impact on one’s mental health. 

Understandably, suffers ultimately find themselves turning to long term pain management, often including highly addictive medications such as opioids. A frightening reality for patients and doctors alike, with up 26% of opioid users developing a dependency and, in many cases, acute addiction.

Cannabis has been used as a natural form of pain management since at least the 1800s, although many historians believe its use dates back many hundreds, if not thousands of years.  And while the prohibition of the early 1900s was a stumbling block for cannabis research, there has been an explosion of interest in the medical community since California became the first state to permit legal access to and use of botanical cannabis for medicinal purposes under physician supervision in 1996.

Fast forward 25 years and the evidence, both anecdotal and clinical, suggest that cannabis is most certainly a legitimate treatment for chronic pain. Lauded for its ability to reduce pain, as well as the secondary symptoms such as stress and anxiety, medicinal cannabis is also significantly less addictive than opioids and is extremely difficult to take at toxic levels.

The real question, it would seem, are the properties of the plant optimal for pain chronic management?  The answer, as with most cannabis questions is “it depends”.  

The determining factors are broad and specific to the individual. The origins cause of the pain, is inflammation a contributing factor, the patient’s metabolism, their ability to consume THC (i.e. work restriction) and the overall function of their endocannabinoid system (ECS) are all consideration doctors and patients must align on before embarking on a specific treatment. And even then, tweaking will often be required.

Many believe that a THC dominant medicine delivers the most effective form of pain relief, in no small part thanks to the euphoria, aka ‘high’, experienced with high dose THC products.  Moreover, THC has the ability to interact with both of the receptors in the ECS. As with most matters relating to cannabis, more research is required, however, it would seem that THC seems to have a greater effect on the way the mind perceives pain, whereas CBD may work to ease pain at the local source (see what is the difference between CBD and THC?).

Takeaway

The reality is, the most suitable plant-based medicine does still depend on the particular source of pain, the patient’s individual biochemistry, the dosage and even the patient’s occupation.  What we do know for sure, is that there is a path to manage pain that avoids extremely addictive and potentially fatal opioids.