Chronic pain is a prevalent public health issue. Annually, developed and developing nations have a prevalence of 37% and 41% chronic pain cases, respectively [1]. 

 Although there are prescriptive and over the counter drugs for pain relief, some prefer to seek help from alternative plant-based medicines. Cannabis is becoming increasingly relevant in the chronic pain medication scene. According to the Australian Institute of Health and Welfare, in 2018 3.24 million Australians were facing chronic pain, and it’s expected that by 2050, 5.23 million will be living with chronic pain in the country. 

 Cannabis for chronic pain relief 

 Cannabis is currently categorised under the banner of “cannabinoid drug [3].” There are over 200 compounds in the cannabis plant, including terpenes, cannabinoids, fatty acids, and flavonoids. 

 The pain-relieving attribute of cannabis is mainly based on its reaction to the human endocannabinoid system or ECS [4]. The ECS is involved in several processes that help regulate reproductive functions, immune functions, metabolism, sleep, stress, appetite, mood, memory, and pain [5,6]. 

 There is a growing pool of research, history, and anecdotal data supporting the role of cannabis for the relief of several types of pain. The National Academies of Sciences suggested that adult chronic pain patients under cannabis treatment are most likely to experience a reduction of symptoms [7]. 

 Of course, effects may vary according to the strain used, method of administration, doses, and the condition being treated.  

CBD and THC pain relief mechanisms 

CBD (cannabidiol) and THC (tetrahydrocannabinol) are two of the most well-known compounds found in the cannabis plant with potential medical benefits. 

 The medical effects of CBD and THC mostly lie to their ties with the ECS’s receptors [4]. These receptors are chemical compounds found throughout the body. They’re responsible for several events like relieving pain, inflammation, and so on. Cannabinoids binds with these receptors; hence, CBD and THC can potentially influence on how the ECS relieves pain.  

 The ECS’s receptors are divided in two types: CB1 and CB2. CB1 receptors are mainly found in the nervous system, while CB2 receptors have huge clusters in the digestive system and immune cells.  

 THC binds with CB2 receptors to help modulate pain. CBD on the other hand, can’t bond well with CB1 and CB2 receptors but it helps prevent the pathways responsible for inflammation, which ultimately leads to analgesic and anti-inflammatory effects [8]. In addition, CBD lessens the psychoactive effect (or the feeling of “high”) of THC. 

What is best for pain relief? CBD or THC? 

There is no conclusive data answerable to the question of the better cannabinoid for chronic pain. However, CBD has more clinical trials with positive results compared to THC [9].   

Some of the landmark research on CBD for pain relief are:  

  1. For chronic pain: In a research done by the National Academy of Sciences, they highlighted that high-CBD cannabis strain-based products have the potential to relieve chronic pain [7]. Another study published in 2012 suggests CBD can reduce pain and inflammation [10].
  2. Digestive pain: CBD for digestive pain is still in its early stages of research, but it showed potential after several evidences have been recorded in a 2017 study [11]. 

THC also has the potential to treat pain, especially cancer-related chronic pain. However, THC’s psychoactive effect makes it a less desirable option compared to CBD. 

Ideally, you don’t have to choose between CBD and THC for chronic pain. The two cannabinoids work synergistically together to create a desirable effect. In fact, research tells us that it might be wise to consider the whole cannabis plant for chronic pain treatment as its compounds interact with each other to provide that entourage effect [9]. 

In theory, the entourage effect is the collaboration between cannabis’s compounds that when taken as a whole, provides a better effect compared to a single compound. 

If you are seeking medical cannabis as a treatment option for your chronic pain, it is essential to consult with a cannabis doctor, nurse or specialist. During the consultation, your condition will be analysed, and you’ll be prescribed with the option that best suits you, whether that is a THC or a CBD product, or a combination of both. 

CanView does not endorse the use of Medicinal Cannabis without lawful prescription. Just like any Medicine, Medicinal Cannabis may have both positive and negative side effects on the user, and should only be prescribed to patients by a Health Professional with the authority and expertise to do so. The information provided by CanView is for informational and educational purposes, and is of a general nature. If you are interested in accessing Medicinal Cannabis please talk to your doctor and request a referral to a Medicinal Cannabis clinic.  

 

Endnote:

  1. Tsang A, VonKorffM, Lee S, et al. 2008. Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression-anxiety disorders. Available at: https://pubmed.ncbi.nlm.nih.gov/18602869/
  2. Orhuru, V, et al. 2020. Cannabis Use in Hospitalized Patients with Chronic Pain. Available at: https://link.springer.com/article/10.1007/s12325-020-01416-9#ref-CR2
  3. Alcohol and Drug Foundation. 2020. What is Cannabis? Available at: https://adf.org.au/drug-facts/cannabis/
  4. Manzanares J, Julian M,CarrascosaA. 2006. Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430692/
  5. Alger BE. 2013. Getting High on the Endocannabinoid System. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997295/
  6. MaccarroneM, Bab I, Bíró T, et al. 2015. Endocannabinoid signaling at the periphery: 50 years after THC. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420685/
  7. National Academies of Sciences, Engineering, and Medicine. 2017. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Available at: https://www.nap.edu/catalog/24625/the-health-effects-of-cannabis-and-cannabinoids-the-current-state
  8. Bruni N, DellaPepaC, Oliaro-Bosso S, Pessione E, Gastaldi D, Dosio F. 2018. Cannabinoid delivery systems for pain and inflammation treatment. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222489/
  9. Peki, Winston. 2018. THC vs. CBD for Pain: The Differences and Interactions. Available at: http://nationalpainreport.com/thc-vs-cbd-for-pain-the-differences-and-interactions-by-winston-peki-8837164.html
  10. Xiong, W, et al. 2012. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371734/
  11. Hasenoehrl, C, et al. 2017. Cannabinoids for treating inflammatory bowel diseases: where are we and where do we go? Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388177/

Related Posts