In cannabis education there are two main types of knowledge we rely on: empirical knowledge and clinical knowledge. Clinical knowledge involves a cognitive understanding of known clinical rules and principles which have a foundation in medical literature, that may include medical studies, peer-reviewed research papers and other scientific based literature. On the other hand, empirical knowledge involves the observation of behaviours, patterns and outcomes for an individual or group over an extended period of time and is completely subjective in nature.
This blog will explore both the empirical knowledge we have about cannabis for pain relief, as well as the evidence-based science behind the power of the plant. Until legalization occurred in 2018, cannabis research was illegal and difficult to come by. Now that recreational cannabis is legal in Canada, the studies are forthcoming and will likely support the empirical knowledge that we already have.
What is Pain?
Pain can take on many forms, including chronic pain, migraines, back pain, aches and pains, headaches, arthritis, muscle spasms or cramping. Pain, in all of its forms, is one of the leading causes of disability in Canada and does not discriminate based on gender, age, or nationality. Pain may affect joints, muscles, nerves or the skin and can range from mild to extreme. Furthermore, researchers are starting to believe that Endocannabinoid Deficiency may play a role in treatment resistant pain disorders and that cannabinoid therapy can be beneficial in managing these conditions.
Dr. Ethan Russo is responsible for the discovery of Endocannabinoid Deficiency (ECD) and published his findings in Neuroendocrinology Letters suggesting that endogenous cannabinoid deficiency could lead to certain conditions and symptomology. “Migraine, fibromyalgia, [irritable bowel syndrome] and related conditions display common clinical, biochemical and pathophysiological patterns that suggests an underlying clinical endocannabinoid deficiency that may be suitably treated with cannabinoid medicines,” Russo concluded in his research review.
Endocannabinoid Deficiency is a condition which involves the underproduction of endogenous cannabinoids or CB1/CB2 receptors by the ECS. When the ECS is deficient it may cause unwanted symptoms to arise or certain bodily processes to be thrown out of whack. The only known treatment for ECD involves cannabinoid therapy. When exogenous cannabinoids are ingested it returns the ECS to a state of homeostasis and often alleviates unwanted symptoms.
How Does Cannabis Oil Work?
When cannabis oil is ingested it introduces exogenous cannabinoids, such as cannabidiol (CBD) and delta-9 tetrahydrocannabinol (THC), into the ECS. Once the cannabinoids enter the ECS they act on the CB1 and CB2 receptors located throughout the body, in a “lock and key” fashion. Essentially, cannabinoids act as keys to unlock the ECS receptor locks, which creates a chemical response in the body. For instance, in pain conditions cannabinoids act on CB1 receptors in the brain and CB2 receptors in the body to block, or reduce, pain signals as well as reduce inflammation, thus reducing sensations of pain.
One of the benefits of cannabis oil is that it is taken orally, rather than smoked or vaporized, and the effects tend to last longer. Cannabis oil is a great choice for medical cannabis consumers with compromised respiratory systems or those individuals who do not like smoking or vaping their medicine.
Cannabis and Pain: The Science Behind the Plant
One of the most prominent studies on cannabis and pain was a 2017 study published in Cannabis and Cannabinoid Research which demonstrated that “cannabis is just as effective, if not more effective, than opioid-based medications for pain”. Ninety-seven percent (97%) of enrolled patients reported that their pain was reduced after using cannabis, and 81% of the sample group reported that consuming cannabis was more effective at managing their pain than using opiate therapy alone. This study suggested that the therapeutic benefits of cannabinoid therapy for pain are promising, although further research is warranted.
Another study, conducted at McMaster University evaluated the effects of a placebo against three different doses of cannabis at managing pain. Cannabis was provided to patients in 9.4% THC, 6% THC, and 2.4% THC applications and the participants were blinded to their dosage. The 9.4% THC dose provided the greatest reduction in pain, with patients reporting a .7 drop on the pain scale. This new study ”adds to the trickle of evidence that cannabis may help some of the patients who are struggling [with pain] at present,” Henry McQuay, DM, an emeritus fellow at Balliol College, Oxford University, England, writes in a commentary accompanying the study.
Another study, published in 2016 in the journal Pharmacotherapy, evaluated the role of cannabinoid therapy in reducing the severity and frequency of migraines. Although this study was performed on an animal model, the results are transferrable to a human population. In June 2017, a study was presented at the Congress of the European Academy of Neurology in Amsterdam and showed that cannabinoid therapy was just as effective at treating migraines as compared to traditional pharmaceutical migraine medications. The authors went on to state that “we were able to demonstrate that cannabinoids are an alternative to established treatments in migraine prevention. That said, they are only suited for use in the acute treatment of cluster headaches in patients with a history of migraine from childhood on”.
Side Effects of Cannabis Oil
Although the side effects of cannabis oil are minimal, they may include headache, dry mouth, dry eyes, light-headedness, dizziness, drowsiness, fatigue, nausea, paranoid thinking, dissociation, increased appetite and coughing. Some of the side effects, such as coughing and dry mouth, are reduced when using cannabis oil as it does not irritate the respiratory tract. Cannabis oil is generally safe and does not interact with other medications, although it is always advisable to consult with a medical professional before using cannabis oil.
The Future of Pain Management
The current studies on cannabinoid therapy for pain are promising and suggest that it may one day have clinical application alongside its pharmaceutical counterparts. Contact Apollo Cannabis Clinics today to find out how cannabinoid therapy, and the use of cannabis oil, may benefit your specific condition.