Exploring the use of CBD and cannabis for pain management is an emerging topic in clinical practice. Although studies demonstrate its efficacy, its safety and ideal administration route remain unknown.
Medical professionals must assess patients thoroughly to make sure that they are comfortable with any associated side effects and are satisfied with this medication. Furthermore, more research needs to be conducted into cannabis-based medications so as to provide definitive evidence.
Cannabidiol (CBD)
CBD is a non-psychoactive cannabinoid that has shown great promise in treating various conditions, as well as providing anti-anxiety and pain relief properties. CBD works by targeting mu and delta opioid receptors to alleviate discomfort while simultaneously engaging 5-HT1a receptors to help control serotonin levels in the brain.
CBD shows great promise in alleviating nerve-pain caused by conditions like shingles, fibromyalgia, diabetes and multiple sclerosis. Furthermore, it prevents the breakdown of fatty acids which reduce inflammation and helps alleviate chronic pain.
Studies have demonstrated that CBD/THC combinations have greater success at relieving pain than either drug alone. Unfortunately, cannabis remains classified as Schedule 1 drug by the US federal government which severely limits research into its medicinal benefits. As a result, before trying CBD for pain management alone it’s wise to consult your physician first.
Tetrahydrocannabinol (THC)
Raphael Mechoulam of Israel discovered in the 1960s that cannabis users experienced a pleasurable “high” after ingesting it. Through investigation and experimentation he and his team discovered that cannabis contains an active compound known as Tetrahydrocannabinol (THC).
THC acts by binding to the CB1 receptor and producing its psychoactive effects, including feelings of euphoria and intoxication. Furthermore, it serves as a painkiller and inflammation reducer by blocking production of cytokines in the body.
CBD acts by binding with the CB2 receptor, helping reduce anxiety and promote relaxation while also acting as a painkiller, though with less of an impactful relief than with traditional medication.
Researchers have studied cannabis’s effectiveness as an analgesic medication and discovered it to be effective against chronic pain in certain cases. However, it should be noted that many individuals using it also make use of other pharmacologic and non-pharmacologic treatments, which has been linked with poorer outcomes such as higher rates of substance abuse issues and mood disturbances.
Cannabinoid receptors
Studies indicate that CBD and its main metabolite, 9-tetrahydrocannabinol (THC), work through the ECS to relieve pain hypersensitivity. Spinal cord receptors appear to be its main target; however, these substances also interact with several other ECS receptors to manage pain, anxiety and mood.
CBD has been shown to reduce pain hypersensitivity by blocking endocannabinoid transporters, increasing cAMP levels, and desensitizing TRPV1. This treatment method has proven particularly successful when treating neuropathic pain.
Cannabis is currently used anecdotally to treat many medical conditions, including fibromyalgia and chronic neuropathic pain; however, more research needs to be conducted into its exact mechanisms of action. Pharmacists should also be informed about potential risks and benefits of cannabis use as well as any recent studies regarding medical cannabis so they can inform both patients and clinicians on appropriate products/dosages; including understanding its safety/effectiveness via different delivery methods such as oral or intramuscular injection.
Cannabinoids and pain
Researchers are investigating the use of CBD and THC combined with opioids as pain management treatments, using human models and animal models alike, to understand both benefits (primarily pain relief) and risks ( mainly addiction potential) associated with such combination strategies.
Studies on CBD suggest it may reduce neuropathic pain, spasticity and nausea by acting upon CB receptors. Furthermore, CBD may prevent chemotherapy-related nausea and vomiting by acting upon these same receptors.
Other studies suggest that CBD could be an effective treatment option for children suffering from Dravet syndrome and Lennox-Gastaut syndrome – two epilepsy disorders common among young people – with anti-seizure and anti-inflammatory properties that make CBD suitable for these disorders.
Cannabis may interact with numerous medications, including benzodiazepine sedatives like Klonopin (clonazepam) and Ativan (lorazepam), immune-suppressants like Sandimmune (cyclosporine), and antituberculosis drugs like Rifampin (rifampicin). Before beginning taking cannabis, those taking these medicines should consult their health care provider to make an assessment – changing doses or spacing out treatments may be necessary; in extreme cases they may need to avoid cannabis altogether.
