Marijuana and pain tolerance: Regular cannabis use does not increase pain sensitivity

Cannabinoids have been looked at for their pain-relieving properties. As a matter of fact, chronic pain is the most cited reason for medical cannabis. Athletes, for example, use CBD for management. Chronic pain plagues many people and some turn to opioids. However, medication, such as opioids, seem to result in higher pain sensitivity over time. A new study found that cannabis does not increase pain sensitivity over time. 

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Pain and Hyperalgesia

Hyperalgesia, according to Medical News Today is a condition where someone develops an increased sensitivity to pain. Someone with that condition feels significant pain in an instance where most people may not hurt. For some people opioids, which are used to treat chronic pain, may cause hyperalgesia. Scientists posit that since opioids and marijuana use a similar pathway it was worth looking into cannabis to see if it was a better alternative. As you may have heard, opioids sometimes cause addiction as well. Given this, alternatives for effective pain treatment are needed. 

Marijuana as a pain reliever 

Cannabis as an effective pain reliever is rooted in real science. According to a 2017 review of the cannabis literature by the National Academies of Science and Engineering, marijuana is an effective treatment for chronic adult pain. In addition to that, the same review said that most medical marijuana users used marijuana for pain relief. The review stated, “94 percent of Colorado medical marijuana ID cardholders indicated “severe pain” as a medical condition” The review also cited a study that reported, “87 percent of participants in their study were seeking medical marijuana for pain relief.” 

Marijuana doesn’t increase pain sensitivity

A study was done and published in the The Clinical Journal of Pain looked at whether or not marijuana would increase pain sensitivity. The study concluded that cannabis did not. The study which was led by Michelle St. Pierre, used people who used cannabis three times a week and people who didn’t as a control. The volunteers had to submerge their arm and forearm into icy cold water for a certain amount of time. The study found that not only did frequent cannabis users not have an increase in pain sensitivity, they also didn’t exhibit any differences regarding pain tolerance or pain intensity. 

Michelle St. Pierre, who led the study, was quoted in Science Daily saying, “Our results suggest frequent cannabis use did not seem to be associated with elevated sensitivity to experimental pain in a manner that can occur in opioid therapy”. She then continued, “This is an important distinction that care providers and patients should consider when selecting options for pain management. These findings are particularly relevant in light of recent reports of opioid overprescribing and high rates of pain in the population, as it suggests that cannabis may not carry the same risk of hyperalgesia as opioids.”

Can Cannabis replace opioids? 

As we’ve said, opioids, which can be effective pain relievers, have been linked to addiction and an increased sensitivity to pain. Death from overdose from opioids have also killed many. According to the CDC, in “Opioids were involved in 46,802 overdose deaths in 2018 (69.5% of all drug overdose deaths)”. Needless to say, alternatives to opioids are being investigated and cannabis has come up as a front runner. 

According to a survey done at UC Berkeley, people prefer cannabis to opioids and found it to be effective. The paper said, “81% “strongly agreed/agreed” that taking cannabis by itself was more effective at treating their condition than taking cannabis with opioids”. In addition to that, most people said that they did need as much opioids if they use cannabis. The study said, “Ninety-seven percent of the sample “strongly agreed/agreed” that they are able to decrease the amount of opiates they consume when they also use cannabis”

People are replacing opioids with cannabis in Michigan, according to a research, “ survey data from patrons of a Michigan medical marijuana dispensary suggesting that medical cannabis use in pain patients was associated with a 64 percent reduction in opioid use”. 

However, as the UC Berkeley study says, more research is needed. The study said, “Future research should track clinical outcomes where cannabis is offered as a viable substitute for pain treatment and examine the outcomes of using cannabis as a medication assisted treatment for opioid dependence.”

Using Cannabis for chronic pain 

According to Dr. David Bearman, who was quoted in an article on the Practical Pain Management website, the right mix of cannabinoids are key for treating the pain. For people who are afraid of the psychogenic effects he says, “I usually suggest that people start with 7.5 mg [which, using a standard unit converter amounts to 0.003 oz.] of THC and 7.5 mg of CBD, three or four times a day,”. While this mixture won’t make people high, it likely won’t really relieve the pain either. Dr. Bearman believes that less than 15mg of THC won’t be too effective. The article suggests 15mg of THC and 15mg of CBD. 

However, it’s still best to consult with your doctor for the appropriate amount, after all everyone is different. According to the article, “Each person is different, and many adjustments may be needed to zero in on the dose that controls pain with minimal side effects. It’s also important to start on a low dose of THC and CBD”. 

Dr. Bearman also spoke about dronabinol which has synthetic THC. Bearman says that this medication isn’t as good as cannabis, has more side effects and is more expensive. However, according to the article, “dronabinol is regulated by the FDA and must meet purity and manufacturing standards, he knows exactly how much THC a patient is getting.”

Conclusion

Science is showing more and more that cannabis is not only an effective pain reliever but it doesn’t seem to increase pain sensitivity. Of course, more research is always needed but using cannabis to replace opioids or at least being used alongside it is a positive thing and likely to happen. As a matter of fact, it seems to be having already according to people who do suffer from chronic pain.