Ever since medical marijuana, or cannabis, became legal in some states (but not in Florida), there have been qualms about its use in chronic pain patients. However, it may only be a matter of time until medical marijuana becomes legal in the state of Florida. But, is cannabis an effective treatment option for individuals suffering from chronic pain conditions?
Marijuana seems to have a pain relieving effect in some medical conditions when cannabinoid receptors are activated. When smoked, the effects of marijuana can be perceptible almost immediately, with full effects apparent within minutes. Research has shown that marijuana may be an effective remedy for anorexia, nausea, and vomiting in cancer chemotherapy, and HIV/AIDS. Marijuana may also reduce the pain associated with cancer, multiple sclerosis, and neuropathic pain. A Canadian clinical trial reported that participants who took three puffs a day of 9.4% THC herbal cannabis found a slight reduction in pain1. Importantly, information about marijuana’s analgesic properties is limited and its effects on some pain conditions must not be extrapolated to ALL pain conditions.
Despite these mild analgesic and other properties, it is important to note that cannabis use comes with some risks. Marijuana may cause changes in mental status, including changes in perception, hallucinations, delusions, euphoria, and dysphoria. Long term effects of smoking cannabis may include difficulty with memory, anxiety, decreased lung function, chronic airway disease, lung infections, and the potential for substance abuse.2 It has also been shown that cannabis use impairs driving performance by distorting perception, slowing problem solving, and compromising coordination, similar to driving impairments under the influence of alcohol.3
Even though medical marijuana has been legalized in several states, there are still some challenges that need to be overcome. First, the amount of active ingredient, tetrahydrocannabinol (THC), delivered by marijuana varies and the actual percentage of THC in cannabis fluctuates considerably based on the plant’s origin, which part of the plant is being used, the mode of storage, and the cultivation techniques. The amount of THC contained in the cigarettes used in prior research studies may have ranged anywhere between 1% to 10%, whereas the marijuana found on the streets today can have THC levels of 30% or greater. This increased level of active cannabinoids can result in an increased impairment and greater negative side effect.
In conclusion, before considering marijuana as a pain management tool, a number of things need to be considered. Cannabis use has been shown to have some analgesic effects in certain conditions, but there are also risks and side effects. For this reason, synthetic forms of THC, such as Marinol, may prove to be a useful alternative.
As always, consult your doctor before starting a new treatment plan or trying a new method of pain control.
Meriem Mokhtech, BS
Senior Laboratory Technician
UF Center for Musculoskeletal Pain Research
References:
- Ware MA, Wang T, Shapiro S, Robinson A, Ducruet T, Huynh T, Gamsa A, Bennett GJ, Collet JP; Smoked cannabis for chronic neuropathic pain: a randomized controlled trial (2010). Canadian Medical Association Journal 182(14): E694–E701.
- Ashton CF. Adverse effects of cannabis and cannabinoids. Br J Anaesth. 1999;83(4):637-649.
- Sewell, RA, Poling J, Sofuglu M. The effect of cannabis compared with alcohol on driving.Am J Addict. 2009;18(3):185-193.