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Pain – Medical Marijuana Research Overview

The following information is presented for educational purposes only. Medical Marijuana Inc. provides this information to provide an understanding of the potential applications of cannabinoids. Links to third party websites do not constitute an endorsement of these organizations by Medical Marijuana Inc. and none should be inferred.

Overview of Pain and Cannabis Treatment

Studies indicate that cannabis effectively lower pain levels in patients suffering from neuropathic and nociceptive pain, and has even shown it has efficacy in managing pain that had otherwise shown to be resistant to other traditional treatments. Research also suggests that cannabis could address the nation’s opioid painkiller crisis by simultaneously reducing pain and curtailing opioid cravings17.

Pain is a feeling of discomfort — such as a prick, tingle, burn, ache, or sting — that develops after an injury, illness, or in association with a chronic health condition. Pain has the capability of limiting productivity and adversely affecting one’s well-being, and health care costs for treating pain in the U.S. take a toll of $560 billion to $635 billion every year.16

Pain is classified as either acute or chronic. Acute pain develops as a result of an injury of trauma event and will typically subside once its cause is identified and treated. Chronic pain is discomfort that develops in accordance with a chronic disease, such as arthritis or inflammatory bowel disease. Chronic pain often persists over a long period of time and is resistant to many medical treatments.

Contribute to Medical Cannabis Research

Do you use cannabis to treat pain? Learn how you can contribute to medical cannabis research and education.

Major Findings

The volume of studies supporting cannabis’ efficacy as a pain reliever are vast. Cannabis and its major cannabinoids have been found effective at lowering pain levels associated with an array of conditions3,6,10,12,17,18,19,21,22,23,24,25,26. Recently, a survey of medical cannabis users found that cannabis provided a 64% decrease in average pain24.

Cannabinoids are thought to reduce pain through their interaction with the endocannabinoid system, a regulatory network that keeps functions in balance. Cannabinoids interact with the endocannabinoid system’s two main cannabinoid receptors (CB1 and CB2), which adjusts the  release of neurotransmitters in an effort to manage pain levels4,5,8,13,15.

Studies have also demonstrated that using cannabis for pain management is safe23. With the high risk of abuse of pain medications claiming the lives of over 40 Americans everyday, studies suggest that cannabis could prove to be a non-addictive way to treat chronic pain1. Most recently, researchers discovered that vaporized cannabis containing THC caused a “significant analgesic response” in a clinical trial involving 42 patients that had previously found conventional pain-relieving medications, like opioids and non-steroidal anti-inflammatory drugs, to be ineffective26.

Sources

  1. About the Epidemic. (n.d.). U.S. Department of Health & Human Services. Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/.
  2. Abrams, D.I., Couey, P., Shade, S.B., Kelly, M.E., and Benowitz, N.L. (2011, December). Cannabinoid–Opioid Interaction in Chronic Pain. Clinical Pharmacology & Therapeutics, 90(6), 844-51. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1038/clpt.2011.188/full.
  3. Borgelt, L.M., Franson, K.L., Nussbaum, A.M., Wang, G.S. (2013, February). The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy, 33(2), 195-209. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1002/phar.1187/full.
  4. Bosshard, S.C., Grandjean, J., Schroeter, A., Baltes, C., Zeilhofer, H.U., and Rudin, M. (2012, July). Hyperalgesia by low doses of the local anesthetic lidocaine involves cannabinoid signaling: An fMRI study in mice. Pain, 153(7), 1450-8. Retrieved from http://journals.lww.com/pain/pages/articleviewer.aspx?year=2012&issue=07000&article=00019&type=abstract.
  5. Burston, J.J., Sager, D.R., Shao, P., Bai, M., King, E., Brailsford, L., Turner, J.M., Hathway, G.J., Bennett, A.J., Walsh, D.A., Kendall, D.A., Lichtman, A., and Chapman, V. (2013, November 25). Cannabinoid CB2 Receptors Regulate Central Sensitization and Pain Responses Associated with Osteoarthritis of the Knee Joint. PLOS One, 8(11), e80440. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840025/.
  6. Carlini, B.H., Garrett, S.B., and Carter, G.T. (2015, September). Medicinal Cannabis: A Survey Among Health Care Providers in Washington State. The American Journal of Hospice & Palliative Care. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/1049909115604669.
  7. Cottler, L. B., Abdallah, A. B., Cummings, S. M., Barr, J., Banks, R., & Forchheimer, R. (2011). Injury, Pain, and Prescription Opioid Use Among Former National Football League (NFL) Players. Drug and Alcohol Dependence, 116(1-3), 188–194. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3095672/.
  8. Cravatt, B.F., and Lichtman, A.H. (2004, October). The endogenous cannabinoid system and its role in nociceptive behavior. Journal of Neurobiology, 61(1), 149-60. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/neu.20080/epdf.
  9. Emerich, B.L., Ferreira, R.C.M., Cordeiro, M.N., Borges, M.H., Pimenta, A.M.C., Figueiredo, S.G., Duarte, I.D.G., and de Lima, M.E. (2016). δ-Ctenitoxin-Pn1a, a Peptide from Phoneutria nigriventer Spider Venom, Shows Antinociceptive Effect Involving Opioid and Cannabinoid Systems, in Rats. Toxins, 8(4), 106. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848632/.
  10. Fine, P.G., and Rosenfeld, M.J. (2014). Cannabinoids for Neuropathic Pain. Current Pain and Headache Reports, 18(10), 451. Retrieved from http://link.springer.com/article/10.1007%2Fs11916-014-0451-2.
  11. Gerak, L.R., and France, C.P. (2016, May). Combined treatment with morphine and Δ9-tetrahydrocannibinol (THC) in rhesus monkeys: antinociceptive tolerance and withdrawal. The Journal of Pharmacology and Experimental Therapeutics, 357(2), 357-66. Retrieved from http://jpet.aspetjournals.org/content/357/2/357.long.
  12. Hirsh, A.T., Kratz, A.L., Engel, J.M., and Jensen, M.P. (2011). Survey Results of Pain Treatments in Adults with Cerebral Palsy. American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists, 90(3), 207–216. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036542/.
  13. Kinsey, S.G., Mahadevan, A., Zhao, B., Sun, H., Naidu, P. S., Razdan, R.K., Selley, D.E., Damaj, M.I., and Lichtman, A.H. (2011). The CB2 cannabinoid receptor-selective agonist O-3223 reduces pain and inflammation without apparent cannabinoid behavioral effects. Neuropharmacology, 60(2-3), 244–251. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021987/.
  14. Lee, M.C., Ploner, M., Wiech, K., Bingel, Ul, Wanigasekera, V., Brooks, J., Menon, D.K., and Tracey, I. (2013, January). Amygdala activity contributes to the dissociative effect of cannabis on pain perception. Pain, 154(1), 124-134. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549497/.
  15. Li, M.H., Suchland, K.L., and Ingram, S. (2016, December). Compensatory activation of cannabinoid CB2 receptor inhibition of GABA release in the rostral ventromedial medulla (RVM) in inflammatory pain. Journal of Neuroscience, 1310-16. Retrieved from http://www.jneurosci.org/content/early/2016/12/09/JNEUROSCI.1310-16.2016.1.
  16. Pain: Hope Through Research (2015, September 4). National Institute of Neurological Disorders and Stroke. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Pain-Hope-Through-Research.
  17. Perron, B.E., Bohnert, K., Perone, A.K., Bonn-Miller, M.O., & Ilgen, M. (2015). Use of Prescription Pain Medications Among Medical Cannabis Patients: Comparisons of Pain Levels, Functioning, and Patterns of Alcohol and Other Drug Use. Journal of Studies on Alcohol and Drugs, 76(3), 406–413. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440298/.
  18. Roberts, J.D., Gennings, C., and Shih, M. (2006, January). Synergistic affective analgesic interaction between delta-9-tetrahydrocannabinol and morphine. European Journal of Pharmacology, 530(1-2), 54-8. Retrieved from http://www.sciencedirect.com/science/article/pii/S001429990501215X.
  19. Russo, E.B., and Hohmann, A.G. (2012, September 22). Role of cannabinoids in pain management. Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches, 181-197. Retrieved from http://link.springer.com/chapter/10.1007%2F978-1-4614-1560-2_18.
  20. Staahl, C., Olesen, A.E., Andresen, T., Arendt-Nielsen, L., and Drewes, A.M. (2009, September). Assessing efficacy of non-opioid analgesics in experimental pain models in healthy volunteers- an updated review. British Pharmacological Society, 68(3), 322-341. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766472/.
  21. Wakley, A.A., Wiley, J.L., and Craft, RM. (2014). Sex differences in antinociceptive tolerance to delta-9-tetrahydrocannabinol in the rat. Drug and Alcohol Dependence, 143, 22–28. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161674/.
  22. Ware, M.A., Doyle, C.R., Woods, R., Lynch, M.E., and Clark, A.J. (2003, March). Cannabis use for chronic non-cancer pain: results of a prospective survey. Pain, 102(1-2). Retrieved from http://journals.lww.com/pain/Abstract/2003/03000/Cannabis_use_for_chronic_non_cancer_pain__results.23.aspx.
  23. Ware, M.A., Wang, T., Shapiro, S., and Collet, J.P. (2015, September 15). Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS). The Journal of Pain. Retrieved from http://www.jpain.org/article/S1526-5900(15)00837-8/fulltext.
  24. Webb, C. W., & Webb, S. M. (2014). Therapeutic Benefits of Cannabis: A Patient Survey. Hawai’i Journal of Medicine & Public Health, 73(4), 109–111. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998228/.
  25. Wilsey, B., Marcotte, T. D., Deutsch, R., Gouaux, B., Sakai, S., & Donaghe, H. (2013). Low Dose Vaporized Cannabis Significantly Improves Neuropathic Pain. The Journal of Pain : Official Journal of the American Pain Society, 14(2), 136–148. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566631/.
  26. Wilsey, B., Marcotte, T.D., Deutsch, R., Zhao, H., Prasad, H., and Phan, A. (2016) An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain from Spinal Cord Injury and Disease. Journal of Pain, doi: 10.1016/j.pain.2016.05.010. Retrieved from http://www.jpain.org/article/S1526-5900(16)30072-4/fulltext.
  27. Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The role of the endocannabinoid system in pain. Handbook of Experimental Pharmacology, 227, 119-43. Retrieved from http://link.springer.com/chapter/10.1007%2F978-3-662-46450-2_7.
  • September 23, 2015
  • Eve Ripley