Chronic Pain & Weed: Can Marijuana Ease Pain?
While the scientific study of the chemicals in marijuana, called cannabinoids, has led to two U.S. Food and Drug Administration (FDA) approved medications that contain cannabinoid chemicals in pill form, the FDA has not recognized or approved the marijuana plant as medicine.
However, many individuals turn to marijuana in plant form to manage symptoms of illnesses and other conditions such as pain. 
Ongoing research may lead to more medications to help manage or treat medical conditions and illnesses; however, the FDA requires carefully conducted studies in hundreds to thousands of human subjects to determine the benefits and risks of a possible medication.
To date, researchers haven’t conducted enough large-scale clinical trials that show that the benefits of the marijuana plant (as opposed to its cannabinoid ingredients) outweigh its risks in patients it’s meant to treat. 
It is argued that because the marijuana plant contains chemicals that may help treat a range of illnesses and symptoms, it should be legal for medical purposes.
In fact, marijuana for medical use has been legalized in a growing number of states. Relief from pain is by far the most common condition cited by patients for the medical use of marijuana. [1, 3]
In states where medical marijuana use is legal, patients typically must be “certified” by a physician that a benefit from use may result. In order to meet criteria for medical marijuana use, physicians consider factors such as the patient’s failure to respond or benefit from standard medical treatment for a debilitating medical disorder. 
Additionally, physicians are to inform medical marijuana patients about potential adverse effects, which include: 
- Acute memory impairment
- Acute impairment of coordination and judgment
- The development of cannabis use disorder
- Chronic cognitive impairment
- Chronic bronchitis
- Social dysfunction such as struggling at work and or in school
- Increased possibility of motor vehicle accidents
Effectiveness of Marijuana Use for Pain Management
In a review conducted by the National Academies of Sciences, Engineering, and Medicine; it was found that the conclusions of five good, to fair-quality studies on the effectiveness of cannabinoids for pain management were largely consistent in suggesting that cannabinoids demonstrate a modest effect on pain. 
Another review by a team of researchers found that marijuana or cannabinoids are not universally effective for pain, as routes of use and their effects on types of pain differ. More specifically, they discovered that inhaled (smoked or vaporized) cannabis is consistently effective in reducing chronic non-cancer pain. 
Oral cannabinoids seem to improve some aspects of chronic pain (sleep and general quality of life), or chronic cancer pain, but they do not appear effective in acute postoperative pain, chronic abdominal pain, or rheumatoid pain. 
Additionally, the researchers found that the available literature shows that inhaled cannabis seems to be more tolerable and predictable than oral cannabinoids. 
The exact mechanisms showing how marijuana relieves pain are not fully understood yet. Based on current research, it is thought that marijuana reduces pain by interacting with the natural cannabinoid receptors in our body that likely play a role in pain control. 
There is evidence that some individuals are replacing the use of conventional pain medications (e.g., opiates) with marijuana. Some studies have suggested that a decrease in prescription opioid use and overdose deaths could be associated with medical marijuana legalization, but researchers don’t have enough evidence yet to confirm this finding. [1, 3]
Overall, researchers note that there is very little known about the efficacy, dose, routes of administration, or side effects of commonly used and commercially available marijuana products in the United States.
Given that marijuana products are readily available in much of the nation, more research is needed on the various forms, routes of administration, and a combination of cannabinoids to determine their effects on pain. 
About the Author:
Chelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework. She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at ThriveCounselingAustin.com.
1. NIDA. (2018, May 1). Marijuana as Medicine. Retrieved from https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine on 2018, June 22.
2. Schrot, R.J. & Hubbard, J, R. (2016). Cannabinoids: Medical Implications. Annals of Medicine, 48(3), 128-141, DOI: 10.3109/07853890.2016.1145794
3. National Academies of Sciences, Engineering, and Medicine. (2017) The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington, DC: The National Academies Press. https://doi.org/10.17226/24625.
4. Romero-Sandoval, E.A., Kolano, A.L. & Alvarado-Vázquez, P.A. (2017). Cannabis and Cannabinoids for Chronic Pain. Current Rheumatology Reports, 19(11): 67, doi: 10.1007/s11926-017-0693-1.
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Published on July 26, 2018
Reviewed on July 26, 2018 by Jacquelyn Ekern, MS, LPC
Published on AddictionHope.com