For decades, cannabis has been known as an illegal drug, stigmatized and ridiculed. In recent years, scientists have found more and more evidence of its therapeutic potential. Cannabis has become a trusted, daily medication for millions of people across the world, treating conditions ranging from anxiety to arthritis to nausea caused by chemotherapy, without the dangerous and harmful side effects of many popular pharmaceuticals.

WHAT IS CHRONIC PAIN?

Chronic pain is pain that lasts for over an extended period of time (classified as three months). The pain might be there all the time, or it may come and go. It can happen anywhere in your body. It’s extremely common, and one of the most common reasons why people seek medical care. Approximately 25% of adults in the United States experience chronic pain.

Chronic pain hinders daily life, making it harder to work, have a social life, and take care of yourself and others. Sometimes leading to depression, anxiety, and trouble sleeping, which can make your pain worse. This response creates a cycle that’s difficult to break.

WHAT CAUSES CHRONIC PAIN?

There are many causes of chronic pain. It may have started from an illness or injury, from which you may have long since recovered, but the pain remained. Or there may be an ongoing cause of pain, such as arthritis or cancer. Many people suffer chronic pain in the absence of any past injury or evidence of illness.

Healthcare providers call this response psychogenic pain or psychosomatic pain. It’s caused by psychological factors such as stress, anxiety, and depression. Many scientists believe this connection comes from low levels of endorphins in the blood. Endorphins are natural chemicals that trigger positive feelings. It’s possible to have several causes of pain overlap. You could have two different diseases, for example. Or you could have something like migraines and psychogenic pain together.

CANNABIS FOR CHRONIC PAIN?

The most common use for medical marijuana in the United States is for pain control. While cannabis isn’t strong enough for severe pain (for example, post-surgical pain or a broken bone), it is quite effective for the chronic pain that plagues millions of Americans, especially as they age. Part of its allure is that it is clearly safer than opiates (it is impossible to overdose on cannabis and far less addictive) and it can take the place of NSAIDs such as Advil or Aleve if people can’t take them due to problems with their kidneys or ulcers or GERD.

In particular, cannabis appears to ease the pain of multiple sclerosis, and nerve pain in general. This is an area where few other options exist, and those that do, such as Neurontin, Lyrica, or opiates are highly sedating. Patients claim that cannabis allows them to resume their previous activities without feeling completely out of it and disengaged, a far cry from the traditional “stoner” label.

WHAT DOES THE RESEARCH SAY?

In 2017, the National Academies of Science, Engineering, and Medicine (NASEM) determined that there is evidence for cannabinoids to be used for chronic pain in adults. NASEM called for larger studies and long-term safety data.

For non-cancer chronic pain, two review articles evaluating 2,000 patients showed the benefit of cannabis and its pain-relieving effects. For example, cannabis improved pain-related symptoms such as:

• Problems sleeping
• Muscle discomfort
• Quality of life issues
• Patient satisfaction

OTHER WAYS TO MANAGE PAIN

There’s a lot you can do to help yourself and have a better life even with chronic pain. Simple changes can often make a big difference to the amount of disability and suffering you can experience. This is referred to as pain management. Here are some options:

• Activity and exercise: Participating in low-intensity exercises, such as walking or light swimming, for 30 minutes every day may help reduce your pain. Exercise can also be a stress reliever, reduce spasticity, joint contractures, joint inflammation, spinal alignment problems, or muscle weakening and shrinking to prevent further problems for some, which is important to manage when you have chronic pain.
• Better your diet: It’s important to eat healthy to boost your overall health. Your healthcare provider may suggest trying an anti-inflammatory diet by eliminating foods that cause inflammation, such as red meat and refined sugars & carbohydrates.
• Relaxation and sleep: Finding a way to relax can help to reduce pain. Anything which makes you feel good, you enjoy, or gives you pleasure is a form of relaxation. Getting enough quality sleep is important for your overall health. A lack of sleep can cause you to gain weight, which could make your chronic pain worse. Getting quality sleep is also important for stress management.
• Emotional and psychological support: Stress can play a major role in chronic pain, so it’s important to try to reduce your stress as much as possible. Everyone has different techniques for managing their stress, but some techniques include meditation, mindfulness, and deep breathing. Try different options until you find what works best for you.

SCIENCE, SAFETY, AND SIDE EFFECTS

As with any treatment, it’s important to consider safety before using complementary health approaches. Safety depends on the specific approach and on the health of the person using it. If you’re considering or using a complementary approach for pain, check with your health care providers to make sure it’s safe for you.

IN SUMMARY

Early research shows that cannabis can be effective for chronic pain, and it may be an alternative to opioid medications. Cannabis may have fewer side effects and risks when compared to opioids, but it also has some important risks of its own. Larger studies and more long-term data are needed. Make sure to discuss the specific benefits and risks to you with your healthcare provider, here are some questions to ask:

• What might be causing my pain?
• Will it go away? If not, why not?
• Should I try physical or psychological therapy?
• Is it safe to exercise?
• What else can I do to relieve my chronic pain?
• Should I call you if it gets worse?

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