Cannabis and Pain: A snapshot

Recent improvements in access to quality cannabis extracts has given the British public the opportunity to explore other means of treating their pain. Cannabidiol or CBD is just one of over a hundred phytocannabinoids that are produced by the cannabis plant. Due to its weak psychoactivity, and increasing evidence for cannabis access, CBD has emerged as one of the well-known cannabinoids across the globe. This emergence has brought with it a tide of investment and but also a cloud of misinformation. Cannabinoids are by no means the be all and end of medicine as they currently stand. In the last 30 years we have only just begun to shine a light on the vast potential of cannabinoid medicine to treat disease.

The pain measurement scale: https://painrelieffoundation.org.uk/uncategorised/types-of-pain-how-to-recognize-and-talk-about-them/

The focus of this article is to deliver a realistic perspective of what people should expect from cannabinoids if seeking to use them for pain management. Pain is perceived by humans on several levels. Both directly, through the nerves and receptors, and indirectly through the brain. This sensory circuit can be interrupted in several ways with opioids to dull the signals being sent to brain. Cannabinoids offer an alternative method of interrupting this pain circuit and enable us to manage pain in a different way to conventional drugs.

Pain can be experienced in many ways but in general these can be categorised as follows.

  • Acute pain (short term)
  • Chronic pain (long term)
  • Neuropathic pain (Caused by nerve damage)
  • Nociceptive pain (caused by external injury)
  • Radicular pain (spinal pain ie sciatica)

A recent review of research explored the evidence supporting the use of cannabis medicines in various forms of pain. The paper concluded that rather than relieving the sensory perception of pain, cannabis-based drugs instead reduced the perception of that pain, and thus offered an alternate means of pain management. The study’s findings concluded that  cannabis’ effects only offered moderate relief indicating an effect on wellbeing and mood rather than targeted pain relief (Lötsch, Weyer-Menkhoff and Tegeder, 2018).  

Cannabis medicines are in their very early stages of 21st century research and development. We are currently operating at the equivalent level of development as we were with opioids 80 years ago when patients consumed raw opium in a pipe. Not to say that crude consumption doesn't work, it is just a less targeted and precise method of treatment. Cannabis is just the tip of the proverbial iceberg when it comes to this field of research. There is a treasure of knowledge still to be explored. The endocannabinoid system(ECS) is only just being formally recognised in medicine and this physiological element is something that has been overlooked in the mainstream media. Alterations in the ECS have been observed in almost all disease states. This means that we have a new therapeutic target for a whole new wave of treatments for disease.

Cannabis medicines will inevitably be scaled up pharmaceutically, likely in the form of biosynthesis and highly potent synthetic cannabinoids. This progression will likely move in a similar direction as opioid medicines where there are numerous molecules ranging in potency from codeine to fentanyl. This is something that will be possible as we progress with our scientific knowledge and understanding of cannabinoid molecules and their effects within the body.

For more information on cannabis and pain we have attached a literature review of all of the research in the field of cannabis and chronic pain. We hope this can be useful to you or those seeking more information on cannabis and its use as a potential treatment.

 

Reference

Lötsch, J.,Weyer-Menkhoff, I. and Tegeder, I. (2018) ‘Current evidence ofcannabinoid-based analgesia obtained in preclinical and human experimental settings’, European Journal of Pain. Wiley-Blackwell, 22(3), pp.471–484. doi: 10.1002/ejp.1148.