The following information is presented for educational purposes only.
Medical Marijuana Inc. provides this information to provide an understanding
of the potential applications of cannabidiol. Links to third party websites
do not constitute an endorsement of these organizations by Medical Marijuana
Inc. and none should be inferred.
Pain is a feeling of discomfort that develops after an injury, illness or
chronic health condition. Health care costs for treating pain take a toll of
$560 to $635 billion per year. Studies have shown cannabis is highly
effective at lowering all types of pain, including the pain that’s shown to
be resistant to other treatments.
Overview of Pain
Pain, which is an unpleasant sensory experience, is designed as a warning
system that something in the body is wrong. It can be experienced as a
prick, tingle, burn, ache or sting. Pain has the capability of limiting
productivity and adversely affecting one’s well-being. Pain is subjective,
and according to the National Institute of Neurological Disorders and
Stroke, genetics can influence a person’s risk for developing pain, as well
as how sensitive one is to painful stimuli and whether certain therapies
will help alleviate discomfort.
Pain is classified as either acute or chronic. Acute pain is primarily the
result of disease, injury or inflammation. It typically comes on suddenly
and often subsides once its cause is identified and treated. Chronic pain is
the discomfort associated with a chronic disease and it can persist over a
long period of time and is often resistant to many medical treatments.
Chronic pain can cause serious problems and severely affect a person’s
quality of life.
Pain is further classified as nociceptive, neuropathic or psychogenic.
Nociceptive pain (“somatic” or “visceral”) is due to the ongoing activation
of pain receptors in either the surface or deep tissues of the body and is
often associated with inflammation. Examples of conditions that can cause
nociceptive pain include fibromyalgia, rheumatoid arthritis, inflammatory
bowel diseases, HIV and AIDS, and cancer. Neuropathic pain is attributed to
changes in the nervous system that sustain a painful sensation even after an
injury is healed. Psychogenic pain is due to a psychological disturbance
that causes anxiety or depression.
Pain is typically treated with a variety of medications, which could include
acetaminophen, non-steroidal anti-inflammatory agents, and opioids. Opioids,
like morphine, are effective at treating most pain but often come with side
effects like constipation, nausea, and vomiting, and are highly addictive.
Findings: Effects of Cannabis on Pain
The cannabinoids found in cannabis, tetrahydrocannabinol (THC) and
cannabidiol (CBD), have been found effective at lowering pain levels
associated with some cancer, neuropathy, spasticity, headache, migraines,
and other acute pain and chronic pain conditions1,4.
THC and CBD are able to help in the management of pain because they interact
with the two main cannabinoid receptors (CB1 and
of the endocannabinoid system within the body. These receptors regulate the
release of neurotransmitter and central nervous system immune cells to
manage pain levels12.
The studies supporting cannabis’ effectiveness as a pain reliever are vast.
Cannabis has demonstrated the ability to significantly lower pain levels in
patients suffering from neuropathic and nociceptive pain, and has even shown
it can help manage pain that has proven refractory to other treatments2,5,8.
As a result, cannabis use has been found to be prevalent among the chronic
pain population, with improvements in pain, sleep and mood being the most
frequently reported reasons for use9.
One study found that in HIV-positive patients, 94% reported an improvement
in muscle pain and 90% reported an improvement in nerve pain after cannabis
In another study, 12 of 15 chronic pain patients who smoke herbal cannabis
for therapeutic reasons reported an improvement in pain10.
A survey study found that most sufferers of chronic pelvic pain syndrome
reported that using cannabis improved their pain7.
Studies have also demonstrated that using cannabis for the management of
pain is safe. After a year of regular use, patients with chronic pain were
found to be at no greater risk of serious adverse effects than non-cannabis
Despite the clear pain relief benefits that medical cannabis can offer,
health care providers continue to be hesitant to prescribe medical marijuana
for their patients. Just 27% of the health professionals legally allowed to
write medical cannabis authorizations in the state of Washington had issued
the prescriptions because of a lack of education on scientific basis of
medical cannabis or training on the best clinical practices of medical
cannabis, according to a 2015 study3.
States That Have Approved Medical Marijuana for Pain
Nearly all states with medical marijuana laws have approved medicinal
cannabis specifically to treat “chronic pain.” These
states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New
Mexico, Ohio, Oregon, Pennsylvania, Rhode
Island and Vermont.
The states of Nevada, New
Dakota, Ohio and Vermont allow
medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have
approved cannabis for the treatment of “intractable pain.”
Two additional states will consider allowing medical marijuana to be used
for the treatment of pain with recommendation by a physician. These states
include: Connecticut (other
medical conditions may be approved by the Department of Consumer Protection)
and Massachusetts (other
conditions as determined in writing by a qualifying patient’s physician).
D.C., any condition can be approved for medical marijuana as long as a
DC-licensed physician recommends the treatment.
Recent Studies on Cannabis’ Effect on Pain
Twelve of 15 chronic pain patients who smoke herbal cannabis for
therapeutic reasons reported an improvement in pain
Cannabis for chronic pain: case series and implications for clinicians.
Using cannabis has been shown to significantly improve neuropathic pain
that had proven refractory to other treatments.
The effectiveness of cannabinoids in the management of chronic
nonmalignant neuropathic pain: a systematic review.
Baron, E.P. (2015, June). Comprehensive Review of Medicinal Marijuana,
Cannabinoids, and Therapeutic Implications in Medicine and Headache:
What a Long Strange Trip It’s Been… Headache,
Boychuck, D.G., Goddard, G., Mauro, G., and Orellana, M.F. (2015
Winter). The effectiveness of cannabinoids in the management of chronic
nonmalignant neuropathic pain: a systematic review. Journal
of Oral & Facial Pain and Headache, 29(1), 7-14.
Carlini, B.H., Garrett, S.B., and Carter, G.T. (2015, September).
Medicinal Cannabis: A Survey Among Health Care Providers in Washington
American Journal of Hospice & Palliative Care. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26377551.
Jensen, B., Chen, J., Furnish, T., and Wallace, M. (2015, October).
Medical Marijuana and Chronic Pain: a Review of Basic Science and
Clinical Evidence. Current
Pain and Headache Reports, 19(10),
Lynch, M.E., and Campbell, F. (2011, November). Cannabinoids for
treatment of chronic non-cancer pain; a systematic review of randomized
Journal of Clinical Pharmacology, 72(5), 735-744.
Pain: Hope Through Research (2015, September 4). National
Institute of Neurological Disorders and Stroke. Retrieved from http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm.
Tripp, D.A., Nickel, J.C., Katz, L., Krsmanovic, A., Ware, M.A., and
Santor, D. (2014, November). A survey of cannabis (marijuana) use and
self-reported benefit in men with chronic prostatitis/chronic pelvic
pain syndrome. Canadian
Urological Association Journal, 9(11-12).
Wallace, M.S., Marcotte, T.D., Umlauf, A., Gouaux, B., and Atkinson, J.H.
(2015, July). Efficacy of Inhaled Cannabis on Painful Diabetic
of Pain, 16(7), 616-27.
Ware, M.A., Doyle, C.R., Woods, R., Lynch, M.E., and Clark, A.J. (2003,
March). Cannabis use for chronic non-cancer pain: results of a
prospective survey. Pain,
Ware, M.A., Gamsa, A., Persson, J., and Fitzcharles, M.A. (2002,
Summer). Cannabis for chronic pain: case series and implications for
Research & Management, 7(2), 95-9.
Ware, M.A., Wang, T., Shapiro, S., and Collet, J.P. (2015, September
15). Cannabis for the Management of Pain: Assessment of Safety Study
Journal of Pain. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26385201.
Woodhams, S.G., Sagar, D.R., Burston, J.J., and Chapman, V. (2015). The
role of the endocannabinoid system in pain. Handbook
of Experimental Pharmacology, 227, 119-43.
Woolridge, E., Barton, S., Samuel, J., Osario, J., Dougherty, A., and
Holdcroft, A. (2005, April). Cannabis use in HIV for pain and other
medical symptoms. Journal
of Pain and Symptom Management, 29(4), 358-67.
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