Health

Pain, Pain Go Away

Sweet relief may be just an inhalation, sublingual, topical, or edible away.

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.