Posted on January 29 2019
Cannabis use for medical purposes still needs to be researched more thoroughly, but that doesn’t stop researchers and medical professionals from suggesting that they may be a safer alternative the opiates. Research regarding the impact of cannabis on pain, especially chronic pain, has led many states to update their legal guidelines to include “opiate replacement” as a qualifying condition for a cannabis recommendation.
There are many reasons why cannabis as a pain treatment to replace opiates intrigues medical experts, but the main reason is it’s potential to help end the opioid crisis. Evidence suggests that more than 130 people die in the United States everyday due to opioid overdose. The number of people who die from cannabis use is comparatively insignificant, even if undefined.
Many people are turning to cannabis to help manage chronic pain and are getting good results. More doctors are opening up to recommending cannabis in place of other pain medications. Some athletes are even choosing cannabis over common anti-inflammatory medications. Could cannabis put a dent in the opioid crisis? Maybe so. The evidence suggests that it definitely has its place in the treatment of chronic pain and pain disorders.
Cannabis for Pain Research
Many studies have set out to identify cannabis potential for relieving pain across a variety of conditions. Neuropathic pain is a leading reason for opioid prescription, but research suggests that cannabis may be an effective pain-relief option as well. One study suggested that even small amounts of cannabis may effectively relieve neuropathic pain. The study involved 23 participants that experienced chronic neuropathic pain, and the results stated that “a single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis three times daily for five days reduced the intensity of pain, improved sleep and was well tolerated.”
Other concerning conditions that doctors prescribe opiates for is the management of cancer-related pain or pain as a result of cancer therapies. Studies have also shown that cannabis may be a good candidate in this situation. One meta-analysis suggested that cannabis is effective for reducing cancer-related pain. Research suggests that in most cases cannabis was at least slightly more efficient at reducing pain that the controlled placebo group.
Of course, non-cancer related pain is another issue that is often addressed with opiates. Studies have looked at the effects of cannabinoids and THC on refractory pain and have found that it may have the ability to prevent pain by acting at the source. One study identifies cannabis’ effect on the brain that allows it to bing with a3 glycine receptors to prevent pain signals from being absorbed. This is similar to the way that most anesthetics and pain medications work, which may be an explanation for why so many people find relief from pain when using cannabis.
Experts on Cannabis as an Opiate Replacement
Experts are slowly finding comfort in prescribing cannabis to patients who suffer from pain, and some have even come forward to talk about their passion for cannabis as a replacement for opiates. One profound voice in the progression of medical cannabis, Dr. Dustin Sulak, is a huge supporter of cannabis for pain relief. Dr. Sulak is an integrative medicine expert who founded Integr8 health, a medical facility in Maine that helps patients integrate wholesome healing methods, like cannabis.
Dr. Sulak has been very outspoken about his belief that cannabis could end the opioid crisis in our country. He treats over 18,000 patients with medical cannabis, many of which are using cannabis to manage pain. He published an article on Leafly concerning cannabis for replacing opioid medications, where he stated that he has “seen the positive results firsthand.”
He suggested a survey of his patients from 2016 to support the claim, where 542 people who use opiates added cannabis to their health routine. Of these patients, almost 40% of them were able to stop using opiates completely. Nearly another 40% were able to decrease their opiate use. The study even showed an improved quality of life in almost 90% of his patients, and a pain reduction of more than 40% in half of the participants.
Associated Risks of Opiates vs Cannabis
Perhaps the greatest benefit of cannabis vs opiates is seen only when the risks are evaluated. The risks of opioid use are apparent, resulting in high death rates due to overdose. There are other risks associated with opioid use. Drowsiness and sedation are listed as potential side effects of moderate use.
Heavy use is associated with riskier side effects, like paranoia, respiratory depression, and nausea. Long term opioid use is where the real scare lies, which can result in abdominal issues, bloating, constipation, liver damage, and brain damage. Opiates are also often associated with drug dependency, especially because of their proven ability to quickly increase tolerance. Opiates can be fatal in small amounts for some people and can cause lifelong damage to internal organs and bodily functions over time.Cannabis side effects still need to be tested, but the evidence we have suggests far milder effects. One study suggested that dependence is possible, but is usually psychological. It also suggested that the most severe side effects come from symptoms of withdrawal, and include irritability, nervousness, anxiety, restlessness, aggression, and difficulty sleeping. Adverse reactions from cannabis are generally associated with unrealistically high doses, and cannabis is not generally thought to significantly increase tolerance over time.
Final Thoughts on Cannabis and Opiates
Due to legal restrictions, we are still lacking the research needed to identify all of the possible medicinal used of the cannabis plant. However, in many places where cannabis is legal for medical use, chronic pain is listed as a qualifying condition. There are many experts who believe that cannabis could be a pain solution. Experts, like Dr. Dustin Sulak, even suggest that cannabis is a safer alternative to habit-forming opiates and that it may even be more easily tolerated by most people.
If you think that you may benefit from cannabis for pain, talk to your doctor. Your doctor will be able to more accurately assess your health profile to help you decide if cannabis is right for you and your pain conditions. If you do decide to try cannabis for your pain condition, it is often better to ease into cannabis use to avoid mild adverse reactions, like paranoia or nausea, that are associated with taking too high of a dose.
There are many options for using cannabis to treat pain and discomfort, so you should plan a conversation with your physician to help you design a cannabis routine that fits your lifestyle and preference. Do not discontinue using your regular opioid medications without the guidance of your doctor. With a doctor’s guidance, the transition between opiates and cannabis should be slow and steady so as to avoid any harsh symptoms of withdrawal.