Pain, Pain Go Away

Sweet relief may be just an inhalation, sublingual, topical, or edible away.
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Researchers found that among back pain sufferers who consumed marijuana once or twice daily, 89% said “it greatly or moderately relieved their pain, and 81% said it worked as well as or better than narcotic painkillers.”

Researchers found that among back pain sufferers who consumed marijuana once or twice daily, 89% said “it greatly or moderately relieved their pain, and 81% said it worked as well as or better than narcotic painkillers.”

According to the National Institutes of Health, pain is the number one reason Americans go to the doctor. In fact, pain affects more people than diabetes, heart disease, and cancer combined.

But there’s a lot of worry surrounding pain medication right now. Opioids have proven dangerous, and studies continue to show that long-term use of over-the-counter NSAIDs (e.g. Advil, Motrin, and Aleve) can cause stomach and heart trouble. Chronic use of acetaminophen (e.g. Tylenol) also has risks, including liver damage, skin allergies, and even blood cancers.

Fortunately, an alternative is sprouting: cannabis. Although the FDA has not officially approved it for pain relief, there is growing evidence for its effectiveness and its side effects are far less dire.

“One person reporting results is just an anecdote,” says Rosemary Mazanet, M.D., Ph.D., chief scientific officer for Columbia Care, a medical marijuana company. “When you’re charting many people, you begin to see patterns. If a patient orders the same cannabis preparation every month, you know it’s working for them.”

Dr. Mazanet, an oncologist by training at Brigham and Women’s Hospital/ Dana Farber Cancer Institute, bases her clinical judgments on Columbia Care’s database of 200,000 people. She confesses that, as an oncologist, she personally “caused” a lot of pain while prescribing debilitating but ultimately healing chemotherapy to many patients. But she realized something was up when those same patients began turning down her offers of prescription painkillers in favor of cannabis. Based on that kind of evidence, “physicians finally broke down and started listening to patients,” she says.

Related: Natural Alternatives to Narcotics

How does cannabis counter pain? Your body’s endocannabinoid system helps maintain homeostasis—a body in balance. When it detects something amiss, say inflammation in a joint, it calls upon its own cannabinoids (natural compounds akin to those in marijuana) to reduce swelling and pain. But when the ECS is operating inefficiently because of age or stress, supplementing with phytocannabinoids from the cannabis plant can boost its performance, restore balance and dull pain.

THC or CBD? The answer is: yes to both. THC has a well-established capacity to bind with cannabinoid receptors in the brain and short-circuit pain signals. THC is also a natural anti-inflammatory with 20 times the potency of aspirin and twice that of hydrocortisone, according to a 2008 study published in Therapeutics and Clinical Risk Management. CBD, on the other hand, operates all over the body to promote homeostasis and soothe inflammation. Dr. Mazanet suggests that you think of THC as a knockout punch for acute pain, and CBD as a balm for the inflammation that causes chronic pain.

“If a patient orders the same cannabis preparation every month, you know it's working for them.” — Rosemary Manzanet, chief scientific officer for Columbia Care

But THC and CBD are only the two most famous of a hundred different phytocannabinoids that have been identified so far. There may be many cannabinoids that act in concert. “It’s called the entourage effect,” says Joseph Rosado, M.D., the chief medical officer for MarijuanaDoctors.com. “Use everything—the whole plant with all its cannabinoids and terpenes, known and unknown—to supplement the ECS.”

To follow his advice, you’ll need to seek out whole-plant topicals, smoke a joint, or use a whole-flower vaporizer (his strain suggestions are below). Self-experimentation will determine which works best for you.  

Start Here

First, determine why you’re in pain. If you had some sort of accident or sports injury, ingesting THC, or spreading a topical, can provide instant relief. And if you want to supplement that with ibuprofen or acetaminophen, that’s fine, according to Dr. Mazanet. The common side effects of OTC pain medications— stomach distress, intestinal bleeds—won’t be worsened if you combine them with cannabis.

Find Your Dose

That depends on a lot of things—your size, metabolism, degree of pain—but it may be less than you imagine. Pain sufferers in a study conducted at the University of California at San Diego found relief with cannabis containing only 1.3% THC. There is “very little” cognitive impairment at such a low dose, so it won’t mess up your day.

Neutralize Nerve Pain

A 2017 report from the U.S. National Academies of Sciences, Engineering and Medicine examined 10,000 studies related to cannabis. Although only 28 focused on pain relief, researchers concluded that the evidence was strongest for treating nerve pain and cancer-related pain. It was also Dr. Mazanet’s pathway into cannabis-as-medicine: “I learned first-hand about the anguish of my cancer patients,” she says, citing neuropathy as among the worst chemo side effects they experienced. “I used to prescribe Marinol, a synthetic form of THC, but my patients told me they preferred the plant itself. That taught me something about the entourage effect.” 

Stop Back Pain 

It can be caused by a lot of things: Degenerating discs, overuse, or helping to move your neighbor’s couch. Dr. Mazanet describes back pain as “acute on chronic” pain, as in, an existing condition (chronic) that occasionally flares up (acute). Her prescription: THC to provide immediate relief, CBD to fight inflammation long term. Researchers at the University of Colorado’s Spine Center found that among back pain sufferers who consumed marijuana once or twice daily, 89% said “it greatly or moderately relieved their pain, and 81% said it worked as well as or better than narcotic painkillers.” 

Help Your Headache 

Weed may help brain pain by reducing inflammation, easing tension, lowering blood pressure, dilating arteries, slowing pain impulses, or just helping you sleep better. As Dr. Mazanet says: “It can help in two ways: It can actually soothe the pain, or make you not care that you’re in pain.” In a four-year study with 121 adult migraine sufferers, headache frequency declined from 10 to 5 per month with daily marijuana use. 

Soothe Arthritis 

Osteoarthritis and rheumatoid arthritis are two common types; the former results from the breakdown of joint cartilage and the latter from inflammation. Research is ongoing in this area, but because of marijuana’s general pain-relieving and anti-inflammatory properties it could be effective. 

For information on treating dozens of other health conditions with cannabis, suggestions for specific strains to try, and a list of qualified marijuana doctors and dispensaries in your state, visit MarijuanaDoctors.com.

The Doctor Is In (The Dispensary )

Dr. Rosado, chief medical officer for MarijuanaDoctors.com is in the unusual position of having medical credentials and a budtender’s knowledge of what works for his customers. Will these strains work for your pains? Our standard advice applies: Start with a low dose, go slow, and consult your doctor before you try anything or quit any prescriptions. For back pain, Dr. Rosado recommends Bubba Kush (indica), Candyland (sativa), Headband (hybrid), OG Kush (indica), and ACDC (sativa). For headaches: White Widow (hybrid), Green Crack (sativa), Lemon Kush (hybrid), Kryptonite (hybrid), Purple Urkle (indica), Purple Haze (sativa) For arthritis: Burmese Kush (hybrid), Girl Scout Cookies (hybrid), Canna-Tsu (hybrid) For neuropathy (nerve pain): White Widow (hybrid), Purple Kush (indica), Chem Dawg (hybrid), Super Silver Haze (hybrid), Jack Herer (hybrid)

For information on treating dozens of other health conditions with cannabis, suggestions for specific strains to try, and a list of qualified marijuana doctors and dispensaries in your state, visit MarijuanaDoctors.com.