Pot For Pain Relief

(Inside Science) -- Chronic pain can be a debilitating condition, impacting everything from mood and health to overall well-being. Unfortunately, many treatment options aren’t very effective. Worse, commonly prescribed drugs like opioids are highly addictive. They can cause nausea, sleepiness and other side effects. And they are potentially deadly.

According to the National Institutes of Health, more than 115 people die each day in the United States from opioid overdose. It’s become a public health crisis.
But what about using marijuana for pain relief? Could that help address the opioid crisis?

There is some evidence to suggest that cannabinoids -- a class of chemical components in marijuana plants -- can be effective in alleviating pain, either alongside or in place of opioids.

As medical marijuana becomes more accessible in the U.S., it may serve as a safer option for some kinds of pain relief and help reduce the number of people becoming addicted to opioids. But some patients are receiving medical advice from their local dispensary, a trend some doctors are worried about.

“Instead of their provider giving them information on the cannabis in terms of pain relief, they were actually getting their knowledge or obtaining their knowledge from people that had cannabis shops or marijuana type shops,” said Jacquelyn Bainbridge, a clinical pharmacy specialist at the University of Colorado Denver.

Clinical trials are currently underway to examine dosage, side effects, methods for administering marijuana, and its effectiveness at relieving pain. Armed with clinical evidence, doctors can make reliable recommendations for its use as an alternative to opioids.

“So, we don't know exactly what to prescribe, so we need to know what patients are actually doing, so that we know better what to prescribe, or physicians know or health care practitioners know what to prescribe,” said Bainbridge.

“The other big piece is, really, what about drug interactions? We know that there are some drug-drug interactions that occur. We need to have a better handle on what those drug-drug interactions actually look like in order to balance the patient’s other medications that they may be taking. So that’s a big ‘if’ out there. And this kind of research is really important to have done in a well-controlled fashion because you know exactly what the patient is getting, so you know the THC component, you know how the methods are delivered,” said Bainbridge.

Cannabis comes in many different forms -- patients can smoke it, eat it, vape it or use it topically on the skin. Also, different products have different amounts of THC or CBD -- the two most abundant cannabinoids found in cannabis. They both interact with the body’s endocannabinoid system but produce different effects. Doctors are now learning what works best for individual patients.

“Are they consuming a THC product with a little bit of CBD? Are they utilizing a product that has more CBD and low THC? And basically, I think figuring out that ratio for a specific disorder or disease state is also really essential. So, we’ll never know unless we actually conduct the research to figure all of that out,” said Bainbridge.

The bottom line -- will pot replace opioids for pain?

“I don't think it will completely replace opioids for certain types of pain. But I think -- I think it probably shares a role. So, it may decrease the opioid use overall. And we might find out that it’s a safer option for patients than an opioid prescription, which obviously can be lethal for many patients,” concluded Bainbridge.