Patients are increasingly turning to medical marijuana to deal with neuropathic and chronic pain, because cannabis has proven a more effective, non-addictive pain-management option than pharmaceutical medicines.
Neuropathic and chronic pain are bedeviling and varied in the discomfort they cause the sufferer. Some pain is due to central nervous conditions and diseases like cancer, or organ failure. Chronic pain differs from neuropathic pain in that it originates from disease or damage to the skeletal system, organs or tissue, rather than from nerve damage or blunt force impact.
Neuropathic pain is sometimes associated with peripheral neuropathy and the likes of diabetes. It’s generated by and has origins in nerves themselves, rather than by nerves transmitting pain signals from damaged organs or bodily tissues. Neuropathic pain is sometimes confused for or co-diagnosed with another condition called fibromyalgia.
With neuropathic pain, nerves are impacted by pressure, excess stimulation or physical degradation. Someone with narrowing of the space between vertebrae has pain because the narrowing puts a vise grip on nerve roots that join the spine at that vertebral location.
This pain is felt at the nerve root impingement site, but also along the nerve route. This is how the dreaded sciatica often manifests, with the sufferer experiencing a searing, debilitating pain originating in the spinal area that travels down one or both legs along the route of the spinal nerve.
Neuropathic pain can also occur because of infections like the herpes zoster virus or shingles, trauma to the body, or from complications arising from diabetes. Because of its pervasive nature — i.e., a pain with vague causation that’s extremely disruptive to normal functions like movement and sleep — sufferers of neuropathic pain have commonly turned to opiates, prescription nerve-pain medication like Gabapentin, injected nerve blockers, electrical stimulation, massage, acupuncture, surgery and even antidepressants.
The same is true for chronic pain and those people suffering from fibromyalgia who are finding that standard therapies don’t work well, if at all, or that the side effects outweigh the benefits. For these reasons, people are frequently seeking out medical marijuana, which is known for having analgesic, anti-inflammatory, muscle-relaxing effects.
CBD Vs. THC For Neuropathic And Chronic Pain
Medical marijuana patients using cannabis to mitigate chronic pain have few objective scientific studies to help their cannabis choices, because prohibition and the federal government’s ruling that cannabis is an illegal Schedule I substance with no medicinal value means research is limited. Consequently, these limitations have a knock-on effect for cannabis availability and research protocols.
The efficacy of medical marijuana in treating nerve pain has been documented by anecdotal reports.
One patient might find that cannabis completely eliminates their chronic or neuropathic pain, but another person using the same product for the same type of pain might feel decidedly less relief.
Patients who report that medical marijuana mitigates pain more than any other intervention describe a variety of methods for consuming cannabis medicinally.
Some people smoke or vaporize whole cannabis and report the most relief from Kush and indica strains, while others get more relief by turning whole cannabis into medibles, tinctures or topical oils.
How can we assess the relative efficacies of different ways of using cannabis? As a person who uses cannabis to combat neuropathic and chronic pain, I find that whole flower and topical cannabis are the most effective forms that offer minimal side effects.
I must also stress that it’s a mistake to say CBD (cannabidiol) by itself is as useful as whole cannabis. There’s a misguided segment of the cannabis community who turns their noses up at THC (tetrahydrocannabinol) or downplays its medical efficacy, claiming CBD is the predominant medicinal component of weed.
I’ve grown and used cannabis strains that tested at less than two percent THC and at least 12–25 percent CBD. Those strains have interesting, some would say “entertaining” effects, with the main asset being muscle relaxation.
However, the high-CBD strains only offered passing comfort when it came to my neuropathic pain, and didn’t even get rid of headaches as well as Aspirin does. I find more pain relief from high-THC Kush and indica strains, and I’ve heard similar reports of CBD versus THC from other pain sufferers.
Rather, it’s the entourage effect provided by whole cannabis and full-spectrum natural cannabis extracts that creates an interactive dynamic between THC, CBD and terpenoids, which offers more medical benefits than single-cannabinoid CBD products ever could.
The Fallacy Of Marinol & Nabilone Medical Efficacy
There are dozens of clinical research studies investigating whether cannabis or any of its constituents mitigate neuropathic and chronic pain without creating any psychoactive side effects.
But one of the common problems with research involving cannabis and the way these findings are interpreted is that it’s often biased, therefore research protocols are unprofessional and compromised, which leads to errant or misleading results.
Take the National Center for Biotechnology Information (NCBI) review study about cannabinoids and fibromyalgia, which made the error of using a prescription pharmaceutical called nabilone as its “marijuana” component. Much like the other well-known pharmaceutical cannabinoid dronabinol (commonly known by its brand name Marinol), nabilone is a laboratory-created synthetic that attempts to mimic the effects of THC.
Before I started growing cannabis — and because I was living in a prohibition state, which made me unable to get my hands on real weed — I was prescribed Marinol and nabilone. And those expensive pills made me feel so sick.
The manufacturers of Marinol and nabilone claim these drugs are a direct synthetic analog to THC, but to me they felt nothing like real, plant-based THC or THCA extracts from whole cannabis.
Nabilone and Marinol made me dizzy, depressed, nauseous and lethargic. The official list of negative side effects for nabilone and Marinol is long and give good reason to not use either drug.
Neither nabilone nor Marinol got rid of my pain. In fact, they seemed to make it worse, and created an ugly, overdosed, green-out feeling, like a sinister echo of a normal marijuana experience — one which, instead of making you feel high, makes you feel low.
The Drug Enforcement Administration has cannabis listed as a Schedule I controlled substance with no medicinal value, which places it in a category alongside the most dangerous drugs, including heroin and LSD. However, nabilone and Marinol are on Schedule III, making them easily available with a doctor’s prescription.
Possibly the only benefit of being prescribed Marinol or nabilone is that in the past, they may have been able to help you fool a drug test, because synthetic THC metabolites would show up much like if you were consuming real marijuana. This would have allowed you to challenge a dirty drug test, so long as you had a prescription for the synthetic THC. However, with drug-testing technology becoming more precise, it’s likely that urine samples would now be able to distinguish between cannabis and Marinol, so it’s not advisable to attempt this.
Medical Marijuana Can Reduce Pain
In the NCBI’s nabilone-fibromyalgia research article, the authors concluded:
We found no convincing, unbiased, high quality evidence suggesting that nabilone is of value in treating people with fibromyalgia. The tolerability of nabilone was low in people with fibromyalgia.
This finding is often cited by anti-drug crusaders to suggest it’s the synthetic cannabis components of nabilone, and therefore cannabis, that has no value in treating people with this condition, when in fact it was nabilone that failed to treat fibromyalgia, not cannabis.
Fortunately, separate research acknowledges that cannabis helps people with neuropathic pain and fibromyalgia, and that not only can cannabis reduce pain, but it also may be able to restore neural function, protect against nerve damage caused by stroke and traumatic brain injury, and stimulate neural regeneration.
Initial research leads to intriguing findings and questions about whether cannabinoids and terpenoids can be some kind of nutriment or tonic for damaged nerves.
In a 2010 clinical study about cannabinoids and neuropathic pain published in the Canadian Medical Association Journal, researchers suggested that smoked cannabis mitigates pain, including neuropathic pain, in ways that other medicines cannot.
Then, a 2015 clinical study published by the NCBI discussed the effectiveness of cannabinoids in the management of chronic neuropathic pain, with researchers finding that:
Cannabis-based medicinal extracts used in different populations of chronic nonmalignant neuropathic pain patients may provide effective analgesia in conditions that are refractory to other treatments. Further high-quality studies are needed to assess the impact of the duration of the treatment as well as the best form of drug delivery.
Research also indicates that exercise can help fight neuropathic pain, and the use of cannabis to facilitate and enhance workouts is steadily gaining in popularity. Indeed, putting cannabis and exercise together has given me many benefits, because vaporized cannabis almost immediately reduces muscle tension and pain, leading to a more pleasurable gym session.
What Kind Of Cannabis Strain Is Best For Pain Management?
People who suffer from neuropathic or chronic pain are often advised to go for Deadlights or any high-CBD strain. I’ve grown and consumed nearly two-dozen types of CBD whole cannabis. I’ve also used CBD crystal by itself. Using whole-CBD cannabis, I experienced moderate to minimal pain relief and muscle relaxation, while pure CBD crystal gave me a higher degree of pain relief and muscle relaxation.
In both cases, the relief rapidly wore off. The same happened when I consumed CBD medibles, tinctures and topical lotions. I’d heard that CBD strains don’t get you high, and you hear some patients saying they want to use CBD by itself or high-CBD strains so they don’t get high. What physiological mechanism allowed me to get high from a CBD strain? I conclude that it’s the same mechanism that gets me high when I use terp sauce, which is pure terpenoid extracts with no cannabinoids.
CBD strains contain just as many if not more terpenoids than high-THC strains. Terpenoids on their own have noticeable effects. Combine terps with CBD and you get even more noticeable effects. And even when seed breeders claim that their CBD strain has little or no THC, most of those strains do have at least 4–5 percent THC.
However, I did indeed get high using some CBD strains — and it was enjoyable. Frankly, I find it strange that anyone would see euphoria and other facets of being high as a negative experience.
On the other hand, when I consume THC-rich marijuana strains, I not only experienced worthwhile pain relief, but also a recreational high that takes my mind off the pain.
People who live in legalized states and suffer from fibromyalgia, chronic pain or neuropathic pain have access to well-stocked dispensaries and consequently have a far easier time sourcing CBD in any form that will help them medically.
My recommendation if you live in those states is to first start out by purchasing small amounts of high-CBD bud, along with CBD creams, tinctures and edibles. If you can find CBD crystal, try that, too.
By administering each type of CBD product when you aren’t already medicated and carefully monitoring and recording the effects, you may find which, if any, CBD medicines give you the relief your body craves.