Finding relief from chronic pain is one of the major reasons that many people apply to the MCPP. Medical cannabis is a life saver for some, a game changer for many, but in some cases, it is ineffective. The question that is often asked is how does medical cannabis actually relieve pain?
And the answer is: Cannabis isn’t a painkiller, it is a distracter from the pain and THAT is what makes it much more tolerable. That would explain why it doesn’t work for everyone because pain is so subjective and unique to each person. How each person perceives pain is based on several different factors including:
- Incoming signals from the injured site
- Cognitive factors – how much attention you pay to the pain
- Contextual factors – how painful you expect it to be
- Mood factors – if you are depressed or anxious
- Genetics – your tolerance for pain
- Chemical factors – how well your endocannabinoid system functions
A study by Oxford researchers that was published in the journal PAIN in December, 2012, came to the same conclusion. The results indicated that cannabis acts differently than conventional pain medicine. Cannabis does not reduce pain, as such, but it makes the pain more bearable.
This was based on using healthy volunteers who had never used cannabis, MRI scans, doses of THC and 1% capsaicin cream. Michael Lee, lead author of the study, noted that “brain imaging shows little reduction in the brain regions that code for the sensation of pain which is what we tend to see with drugs like opiates. Instead, cannabis appears to mainly affect the emotional reaction to pain in a highly variable way.”
Each of 12 subjects was given either a tablet of THC or a placebo. In order to induce pain, they rubbed the legs of the volunteers with a cream with 1% capsaicin which derives from chili peppers. It caused a burning sensation on the skin. The subjects were asked to rate both the intensity and discomfort of the pain; how much it burned and how much the burning bothered them. For those who took THC, for the most part, the intensity was the same as those who took the placebo. However, the pain bothered them less.
Each participant was given an MRI of the brain to identify the areas that were implicated in the processes of THC pain relief. The changes in brain activity was in the anterior mid-cingulate cortex which deals with the emotional responses to pain rather than the areas associated with direct physical perception of it. This supports the theory of Michael Lee and his team. In addition, there was a big variation between subjects in how effective the THC was in reducing the unpleasant sensation of pain. For some, it was significant and for others, there was little effect.
The MRI scans further corroborated this finding. Those who were more affected by the THC showed more brain activity which connected the right amygdala with the part of the cortex called the primary sensorimotor area. Brain activity scans may be used in the future to diagnose which patients might find THC to be the most effective option for pain relief.
If you are having trouble finding relief for your pain, then listen to the advice of Dr. Michael Hart, the head doctor at Marijuana for Trauma in Canada. He subscribes to the adage that “less is more.” Indicas seem to provide more pain relief than sativas or hybrid strains. Low to moderate doses are the most effective while higher doses can exacerbate the pain.
I hope this article explains why some patients do not find relief from chronic pain with medical cannabis even after extensive trial and error with strains, dosage and delivery methods.
Source: Smithsonian.com, Marijuana Isn’t A Pain Killer — It’s a Pain Distracter, Josh Stromberg, December 20, 2012
Leafly.com, Part 2, How Cannabis Enhances the Effects of Opioids, Josh Kaplan