The Benefits of Cannabis in Chronic Pain Treatment
Medical Cannabis is highly effective in reducing pain levels, improving mood, reducing anxiety, and promoting restorative sleep with few or no unwanted side effects.
Published on 04/01/2021
Curated and edited by Sechat Content, with information from Health Europa
Cannabis has been used to relieve symptoms of acute and chronic pain for over 5,000 years. This is due to its ability to alleviate pain with minimal side effects - particularly compared to stronger pharmaceutical analgesics, which can lead to addiction and long-term physical harm.
With a growing number of countries around the world moving to legalize medical Cannabis and consumer demand increasing as patients become more aware of the potential benefits of plant-based medications, and the existence of care centers, such as the Pain Clinic in Malta, Europe, that are turning to medical Cannabis to meet the complex pain management needs of vulnerable patients. Dr. Andrew Agius, medical director of the Pain Clinic, discusses the benefits of medical Cannabis in pain treatment.
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What benefits does medical Cannabis offer in chronic pain treatment?
Chronic pain is a common debilitating condition that affects 20% of the population in Europe. And, after the Covid-19 pandemic, the incidence of chronic pain is expected to rise. Unfortunately, there are very few pharmaceutical medications that can be used to effectively relieve chronic pain; and these often also cause side effects that can exacerbate disability. Recent research shows that the endocannabinoid system is heavily involved in the pathophysiology of chronic pain. Patients who develop chronic pain often have a genetic predisposition to it, which may be related to a dysfunctional endocannabinoid system. Loss of homeostasis and imbalances in neurotransmitter levels often contribute to the symptoms of patients with chronic pain.
THC and CBD are two potent therapeutic substances from cannabis that can help rebalance the endocannabinoid system and thus improve chronic pain symptoms. Full-spectrum medical cannabis preparations contain more than just THC and CBD: they contain over 140 therapeutic cannabinoids, as well as terpenoids and flavonoids that continue to enhance the synergistic effect. This results in a potent therapeutic effect that cannot be fully explained by the effects of individual cannabinoids alone and is known as the entourage effect.
Medical cannabis is highly effective in reducing pain levels, improving mood, reducing anxiety, and promoting restorative sleep with few or no unwanted side effects. Patients experience a remarkable improvement in their quality of life, and most patients report feeling 'reborn' or that they have been 'given another chance to enjoy life.' Medical cannabis literally gives these patients their lives back, helping them manage their symptoms better than anything they would have tried before.
What key areas should further research focus on to support the role of cannabis in pain management?
We know that full-spectrum medical cannabis is much more effective in relieving chronic pain than single-molecule THC or CBD. This is due to the synergistic effect of cannabinoids with the other therapeutic substances in the plant. Everyone responds differently, and some patients respond better than others. We can see the incredible therapeutic potential of this plant, but there is still much we do not know and much we need to explore. It may take decades before we fully understand the different therapeutic substances of this plant.
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THC has been extensively studied in chronic pain, and we have strong evidence supporting its use. Further research should investigate the role of CBD, CBG, CBC, CBN, and other cannabinoids as treatments for chronic pain, both alone and in combination. Hopefully, changes in laws around the world will allow us better access and make this research easier.
What key factors should doctors keep in mind when prescribing medical cannabis?
Medical cannabis is relatively safe compared to pharmaceutical medication, as it has fewer side effects and is better tolerated. However, there are contraindications during prescribing, and doctors should also be aware of possible drug interactions.
Since THC can cause psychosis in 1% of the population, doctors should screen for a possible family history or any symptoms that may indicate an increased risk. Using strains or products with higher CBD levels and lower THC levels would reduce the risk of patients developing psychotic side effects, as CBD is an antipsychotic. Medical cannabis with high THC levels is also contraindicated in patients who are pregnant or breastfeeding, or who have unstable heart problems.
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As patients respond differently, it is advisable to start with a low dose and increase very slowly until a therapeutic effect is achieved. But above all, it is unlikely that patients will experience side effects with these doses. Intoxication can occur with higher doses of THC, but it usually disappears within a few hours without any long-term consequences.
How do you foresee the evolution of the medical cannabis landscape in Malta over the next year?
As the production of medical cannabis in Malta is set to begin later this year, we expect several new products to be available in pharmacies from various companies that will slowly start their operations in the coming months. Therefore, the prices of medical cannabis products should drop drastically (currently, medical cannabis flowers are sold for 16 euros per gram). We expect to see a wide variety of CBD and THC products in various forms and preparations. Additionally, Malta is expected to become one of the first countries in Europe to produce EU-GMP cannabis medicines, which will be available locally and exported to the rest of Europe.
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