Cannabis for Chronic Pain

Approximately 18% of Canadian adults over the age of 18 suffer from chronic pain. Chronic pain is often debilitating for those who experience it, so much so that it negatively impacts their mood, ability to engage in day-to-day functions, and overall wellbeing. Unfortunately, many treatments are not effective enough, so people are turning to cannabis for chronic pain treatment. Additionally, opioids, the most potent prescribed pain medications, are highly addictive and can be toxic. Cannabis is a safer method for managing chronic pain.

Description of Chronic Pain

Pain becomes chronic when it lasts three months or longer. The causes of chronic pain can vary significantly but are often related to previous injury or long-term health issues, for example, multiple sclerosis (MS), arthritis, fibromyalgia, etc. Chronic pain can also occur with no known cause.

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Chronic pain is often accompanied by other health problems, such as fatigue, sleep disturbance, decreased appetite, mood changes, and may limit a person’s movements, which can reduce flexibility, strength, and stamina.

Cannabis for Pain Relief - What the Research Says

People use cannabis for chronic pain because it helps to reduce inflammation, hyperalgesia (increased sensitivity to pain) and manage stiffness. Studies have also found cannabis can reduce pain by affecting how pain receptors respond to stimuli. Here is some of the research supporting the use of cannabis for pain management.

• A 2017 study found that those who used cannabis for several pain disorders experienced a better overall quality of life due to reduced pain symptoms. Most participants preferred cannabis over prescription medication, many of which were prescribed opioids.
• In a 2011 study of individuals diagnosed with fibromyalgia, cannabis significantly reduced their experience of pain and stiffness, enhanced relaxation, and increased their overall feelings of wellbeing.
• In 2016, a study reviewed data from more than 100 adults with migraines whose doctor recommended prescription medication or cannabis. The study found that overall migraine attacks decreased from 10.4 to 4.6 a month using cannabis.
• In an extensive survey of medical cannabis users in Arizona with chronic pain, 77% of fibromyalgia patients, 63% of patients with arthritis, and 51% of patients suffering from neuropathic pain reported experiencing “a lot” [of] or “almost complete overall relief.”

Cannabis can also help to manage chronic pain by simultaneously managing symptoms or conditions that accompany the pain. One of the most significant factors that negatively impacts pain management and overall wellbeing is not getting enough sleep. Those who struggle with ongoing pain often have difficulty falling asleep and staying asleep.

Cannabis for Improved Sleep

Cannabis shortens the time it takes to fall asleep for people regardless of whether or not they usually have trouble with sleep. In a 2011 study, for those with active difficulty falling asleep, cannabis use resulted in an average of 30 minutes less time falling asleep. For those who didn’t have trouble falling asleep, cannabis helped them fall asleep even faster, by approximately 15 minutes.

A 2010 study compared Nabilone – synthetic cannabis – to amitriptyline for reducing pain and managing sleep. They found Nabilone was more effective in improving sleep in patients with fibromyalgia (musculoskeletal pain).

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It’s important to note that THC can impact how long a person is in REM sleep (the most restful sleep stage). This means despite the sleep being longer, it may not be as restful. As a result, it’s generally recommended not to consume cannabis with more than 20% THC right before bed. Many people opt for CBD edibles to manage sleep, such as CBD capsules, as they can help you stay asleep longer and don’t impact your REM cycle.

How to Use Cannabis for Chronic Pain

There are numerous ways of consuming cannabis, all of which could have a different impact on chronic pain. Slow-release options such as capsules or edibles are a great way to manage ongoing chronic pain, for example. At the same time, concentrates, vapes, or smoking a joint can provide faster relief from acute pain and flair-ups.

Another way to use cannabis to manage pain is topicals. Cannabis topicals can be applied directly to the skin at the site of pain. Topicals are often used for muscle and joint pain but can also be used for headaches.

People often mix and match their consumption methods depending on how their pain presents.

It’s recommended to have a regular cannabis routine as well as a solution for acute pain flare ups. Experiment with what works best for you but remember to start with a low dose and increase slowly until you experience the desired pain relief. Note that it’s vital to consider quantity when layering consumption methods to ensure you aren’t taking more than planned.

How Long Do the Effects of Cannabis Last?

• Inhaled cannabis (smoking and vaping): feel the effects almost immediately, and relief lasts between 2-4 hours
• Sublingual (taken under the tongue): 15-20 minutes, and relief can last 4 to 6 hours
• Edibles (gummies, capsules, etc.): feel the effects in 30 minutes to 2 hours, and relief lasts 5 to 8 hours.

Note that these are all approximations, and cannabis can affect people differently. 

CBD vs. THC for Chronic Pain

Currently, there is no definitive answer regarding which is better for pain, THC or CBD. However, there is reason to believe that using them in conjunction can be the most effective way since they interact with different receptors in the body.

For those used to consuming THC, a straightforward way to increase your CBD consumption is to sprinkle a bit of CBD isolate into your joint before closing it. Alternatively, take a half dose of your favourite CBD and THC gummies together.

Those looking for pain relief without the psychoactive experience may opt for CBD only. This may be the best choice for those newer to cannabis or those who cannot consume THC before particular activities. CBD capsules and CBD gummies are a great way to start the day, while a CBD tincture can be taken on the go for pain flare ups.

Topicals for Chronic Pain - Do They Work?

Cannabis topicals are products applied to the skin, such as balms, lotions, creams, etc. Cannabinoids have shown the potential to provide pain relief through managing inflammation. This is believed to be due, at least in part, to the CB2 cannabinoid receptors located in our skin. A 2016 study found that the topical application of CBD had the potential to relieve pain and inflammation associated with arthritis.

Cannabis topicals are often used in addition to other cannabis treatments for pain, particularly for pain associated with the muscles or joints.

This CBD Tiger Balm is specially formulated for pain. Apply generously before engaging in activities that may cause pain as well as afterward.

Cannabis Vs Opioids

Cannabis is a more desirable alternative to opioids for many people. Still, it appears to be just as effective in most cases for pain management. Preliminary research also suggests that cannabis could help manage opioid addictions.

The research on the effects of cannabis and opioid withdrawal is promising. Research suggests that the CB1 receptors play a critical role in opioid reward pathways. CBD has been shown to reduce the rewards associated with the use of other drugs and reduce cravings.

A 2015 report of a small double-blind study conducted in opioid-dependent individuals found that a single administration of CBD compared to placebo decreased cue-induced craving of opioids and feelings of anxiety. A 2019 double-blind placebo-controlled study adds to these findings by demonstrating that Epidiolex (FDA-approved) can reduce cue-induced craving in individuals that had been former heroin users. Furthermore, in these individuals, Epidiolex reduced reports of anxiety and blood levels of cortisol, a stress-related hormone. The reduction in anxiety and stress also contribute to one’s ability to manage withdrawal.

Therefore, CBD can effectively support individuals by decreasing the use of opioids and reducing the chance of relapse.

Initial studies of CBD in humans also provided evidence that CBD, when co-administered with fentanyl, is safe and well-tolerated in healthy, non-opioid-dependent individuals.

Final Thoughts

Cannabis can be as effective as traditional methods for managing chronic pain without the numerous problematic side effects. It helps control the symptoms of pain and improves mood, sleep, and overall wellbeing. Many people of all ages (19+) and backgrounds are turning to cannabis for chronic pain management.

Ready to start exploring the numerous ways you can use cannabis for chronic pain? Check out our online dispensary. If you want to read more about how cannabis can help with serious medical conditions, our next post is on weed and cancer treatment and chemotherapy symptoms .