Medicinal Cannabis and Chronic Pain

Painful stimuli, even in the short-medium term, can alter neuronal pathways that predispose individuals to develop chronic pain.

Chronic Pain and Medicinal Cannabis

A newly released study from Harvard Medical School shows promising results for medical cannabis alleviating chronic pain. 

The lead author presents that their research “provides preliminary evidence that ‘real world’ medical cannabis treatment may be a viable alternative or adjunctive treatment for at least some individuals with chronic pain”.


Chronic pain in the UK

Estimates from across the UK indicate more than 40% of the population experiences chronic pain. This covers a huge spread of conditions such as chronic migraine or headaches, arthritis, endometriosis, fibromyalgia, neuralgia and neuropathic pain from things like injury, cancer or diabetes.

Despite known risk factors and industry advice, opioid prescriptions in the UK are on a worrying trajectory. It is therefore essential to find alternative pain relief for the millions of Brits suffering from chronic pain daily, and medicinal cannabis may be an option.


What defines chronic pain?

Chronic pain is defined by pain exceeding the expected healing time or persisting most days of the week for longer than 3 months and can arise from any number of causes. As many as 10-15% of people with chronic pain in the UK report it to be severe and debilitating, impacting their ability to work, access healthcare and engage in physical activity.

Painful stimuli, even in the short-medium term, can alter neuronal pathways that predispose individuals to develop chronic pain. This along with a plethora of other factors makes treating chronic pain complex, requiring a multi-modality approach to achieve long term successes. 

A holistic approach to chronic pain management can range from encouraging individuals to explore everything from mindfulness practices and psychotherapy to physical activity and occupational therapy.

Despite taking numerous measures, for many suffering chronic pain, they exhaust first-line medications and lifestyle changes. Opioids are second or third line and still valuable for their effective pain relief in acute pain presentations. 

However, it is clear there is a great need for alternative pain management medications for chronic pain sufferers and increasingly it appears that medical cannabis could be next in line.


Harvard cannabis study suggests long term pain relief is possible

The Harvard team, led by Staci Gruber, observed 37 cannabis naive patients with a range of conditions including joint pain, arthritis and neuropathy.

Their findings were documented over 6 months and although representing a small group, showcased daily medical cannabis intake was associated with improvements across a range of measures. The key outcome measured was pain, which significantly decreased in the medical cannabis group compared to the control group.

Furthermore, the need for opioid medications reduced by 13% at 3 months and 23% after 6 months. While these results didn’t reach statistical significance, they are reflective of other research indicating cannabinoid medicines may reduce opioid dependency.

Across other regions inclusive of quality of life, patients experienced notable improvements in anxiety, sleep and mood scores while taking medicinal cannabis.

Chronic pain touches nearly every aspect of patients’ lives. As proven by recent world events, our ability to interact with others is integral to our mental health and emotional landscape. When chronic pain affects sleep, mobility or self-confidence, maintaining social or physical activities can be a challenge. 

Each of these factors can feed into each other creating a perfect maelstrom for poor employment, social and physical outcomes. 

For patients in this study, higher THC intake was associated with greater reductions in pain scores, whilst those with higher CBD medicines showed improvements in mood and from what we already know about these cannabinoids it makes perfect sense.


How medical cannabis helps chronic pain patients

Medical cannabis acts primarily through a fascinating part of our body called the endocannabinoid system (ECS). This body system has influence over pretty much every aspect of our existence -appetite, heart rate, mood, sleep, pain and more.

Medical cannabinoids and endocannabinoids made by our bodies every day interact with receptors all over the body. THC attaches to cannabinoid receptors where it reduces neuron firing that translates to pain sensations.

CBD initiates pain relief and anti-anxiety actions a bit differently. Amongst other actions by increasing the levels of the endocannabinoid anandamide CBD has an indirect, yet still potent action on pain and mood.


Other research supporting medical cannabis for pain

In a trial from 2018 of 177 people with treatment-resistant cancer pain, 43% of patients showed a 30% reduction in pain scores. While this may not seem very large, in terms of pain management it is clinically significant. 

A recent study out of Israel of patients taking medicinal cannabis for chronic pain showed improvements in pain, quality of life and the need for other pain medications for fibromyalgia patients, bolstering previous research showing 50% of fibromyalgia patients ceased pharmaceutical medications with medical cannabis treatment.

Self-reported studies of women with endometriosis pain and patients with arthritis tell a story of widespread use of cannabis to treat pain, detailed human clinical trials are still needed for these conditions in particular.

As we’ve seen, the latest Harvard study’s findings are consistent with other research on chronic pain. Despite the information we already have about how cannabis treats pain, more research is needed to determine the most appropriate formulations and doses for different kinds of chronic pain.

If you’re living with chronic pain and would like to understand more about medical cannabis and whether it might help reduce your pain, check your eligibility here or contact us on 020 3322 4688

By Jessica Kindynis

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