The promise of treating pain with cannabis

Published: November 5, 2019 · Updated: August 28, 2020

pain-illustration Photo by yut548/Shutterstock

You sit all week at your desk. You sit for three hours driving to the cottage. Then you spend two days doing everything but sitting: swimming, boating, raking leaves, splitting wood, going for a walk. Often all that fun leads to sore muscles and joints. Not that long ago treatment was automatic, reach for ibuprofen or acetaminophen. But research is showing that both have side effects. And opioid pain killers, like Vicodin, Percocet, and OxyContin, can be addictive and are tied to the opioid crisis. Increasingly people are experimenting with cannabis to fill the gap.

“It’s no wonder people are are reaching for alternatives to the traditional options,” says Dr. Mark Ware, a medical cannabis expert and chief medical officer of Canopy Growth Corporation, a licensed cannabis producer. “They’re desperate for relief.” For some types of pain, he says, the plant might be just what the doctor ordered.

Health Canada includes chronic and neuropathic, or nerve focused, pain as approved conditions under the medical marijuana laws, which means doctors can prescribe it to treat those conditions. In directions to doctors, Health Canada notes that 54 percent of people with chronic pain experience a 23 percent reduction in severity with cannabis. Other studies have found it more effective at treating chronic pain than opioids.

And while there is plenty of anecdotal evidence of the recreational use of cannabis to treat aches and pains, rigorous clinical studies backing up those claims remain rare.

“Biologically we know why cannabis could treat pain in the body and anecdotally we know that people find relief,” he says. “What we need now is the clinical trials to prove it.”

Another thing doctors do know is mode of administration matters. Smoking or eating cannabis products seems to work the best for managing pain, Ware says. Topicals, like ointments and creams, have little supporting research. “There might be a strong placebo effect,” he notes.

There’s also a lot of unknowns about dosage, timing, and the roll of CBD, and its relationship to THC. The two are acronyms for the most common active compounds in cannabis. THC’s link to pain management is fairly well understood. Non-intoxicating CBD is even more promising, in part because it doesn’t get users high, but is less studied.

Before self medicating, Ware prescribes two steps: 1. Talk to your doctor. “You should work together to understand all the options,” he says. And they can help diagnose the right dose, strains, and possible contraindications. 2. Approach non-medical cannabis products with caution. “If it’s part of the medical cannabis program, the ingredients and any medical claims have been checked by Health Canada,” he explains. If it’s not, there are no guarantees about what you’re buying, including the ingredients, quality, or any health claims.

“It’s great we’re having these discussions in the open, but we still have a long way to go before we’re sure about the therapeutic benefits of cannabis,” Ware says. “Treating pain of any sort is a complex thing. It’s not all about the medication and there is no magic bullet.”