Using Cannabis and Cannabinoids for Pain

Cannabis has been used for the treatment of pain for more than 4000 years.  It was made illegal in the last century but has been increasingly been available legally for all types of treatment, including pain and nausea.  It can even work in the treatment of pain when opioids or other analgesic medication fail to work. 

The Chinese used cannabis in traditional Chinese medical therapy at least 5000 years ago.  Indian texts show usage of the plant at around 2000 BCE for the treatment of migraine pain, visceral pain and neuralgic pains.  Egyptians also used the drug, with remains of hemp found in ancient burial tombs.  Evidence suggests it was used to treat glaucoma and the pain of childbirth.  Assyrians used hemp for the “depression of spirits”.  Ancient Israeli cultures, the Greeks, the Romans, and Islamic countries used hemp (as the young tender leaves) for the treatment of earaches and other types of pain. 

In the Western world, the plant was used in the 1600s for a variety of ailments, including inflammatory diseases, colicky pain, and digestive issues.  They often pounded the leaves in liquid, using the root in boiling water as medicine for disease.  It was also applied to burns as a form of burn treatment.  An Indian form of hemp came to be used in the West, usually for painful conditions.  In such cases, it was used as a tincture for cramping pain, as an antispasmodic, for anxiety, and for chronic pain.  Hemp was applied locally to hemorrhoids and areas of neuralgic pain.  It was also used to speed contractions and deliver babies sooner.  The fact that cannabis was not addictive was noted as well.  Queen Victoria and others used tincture of cannabis for menstrual pain.

In California, cannabis is specifically authorized for medical use with a prescription.

Despite this, insurance companies try to “Paint a picture” and demonize users of cannabis before a jury. Sad but true. 

In 1899, a British pharmacologist, Dixon, studied the drug extensively and added that smoking the drug relieved symptoms faster than other means of giving the drug.  It has especially been found to relieve spasmodic pain and the pain of migraines. 

Modern research equates the pain relief of cannabis to the relief found when taking codeine.  Research has found similarities between cannabis and endogenous opioids.  Other research found that cannabis reduces the release of serotonin in the platelets of patients suffering from migraine headaches.  It seems also to act on the dopamine system, inhibiting dopamine systems associated with pain.  Cannabis inhibits the synthesis of prostaglandin E2, found in inflammatory conditions.  Studies showed that THC, the main ingredient in cannabis was twenty times more potent than taking aspirin and about twice as potent as hydrocortisone.  The seeds of cannabis have been found to have anti-inflammatory properties.  It seems also to potentiate the positive effects of opioids on pain relief. 

Practical Applications of Cannabis Use

A drug called Marinol (dronabinol) is synthetic THC which has been dissolved in sesame oil, a schedule III drug used for various forms of chronic pain, particularly pain associated with cancer and HIV.  It is not as bioavailable as when the drug is smoked (only 25-50 percent bioavailable when compared to smoked THC) because it is heavily metabolized by the liver once ingested.  The cost of the drug is high, in excess of $600 per month at the lowest dosage.  It comes in 2.5, 5, and 10 mg dosage strengths. 

Nabilone is another synthetic THC medication that is said to have a lower abuse potential than regular marijuana. It hasn’t been found to be more efficacious than smoked marijuana and has the side effects of dysphoria and drowsiness.  Levonantradol is another form of synthetic THC that carries the same side effects as Nabilone.  Ajulemic acid is derived from delta-8-THC; it is being tested in animal models as a possible anti-inflammatory medication and pain reliever.

Smoked cannabis is widely used for many different types of pain disorders.  While some tolerance is noted to the side effects of tachycardia and psychoactivity, the pain-relieving effects seem to last indefinitely.  It is used in children for chemotherapy-related nausea with some success.  No deaths have ever been contributed to cannabis toxicity. 

Crude preparations of cannabis contain mostly delta-9-THC, which needs to be heated in order to be active.  This is why cannabis is much better in its smoked form.  Oral cannabis needs to be heated to about 200 degrees Celsius for at least five minutes before it can be effective.  Cannabis has become more potent in recent years but this is considered a good thing because the lungs are exposed to less tar and other substances because there are fewer inhalations to get the same effect. 

Oral THC has its negative aspects.  The uptake of THC is erratic when taken orally and, as mentioned, the liver metabolizes most of it before it reaches the brain and the rest of the vascular system.  If lipids are used at the same time as oral intake of cannabis, the intestinal absorption is markedly enhanced.  It has been found that smoking an unfiltered joint has the best efficacy and works the fastest even when compared to other smoked forms of cannabis.  Rectal suppositories are possible other alternatives to smoking in patients who want to avoid the pulmonary side effects of smoking cannabis.  Some researchers are looking into using THC as a sublingual tablet.  Pure THC aerosolized has been tried but it can lead to bronchoconstriction.  Skin patches are also being investigated for pain control.

If you are suffering from chronic pain from an auto accident or other traumatic injury in Sacramento and have been using cannabis for your pain, contact and experienced Sacramento Personal Injury Lawyer for help.

I’m Ed Smith. Call me anytime at 916-921-6400 or 800-404-5400 for free, friendly advice.

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