abuse. Somewhere between 15 and 20 years ago physicians around the world began recognizing that many patients were using cannabis instead of prescription opioids, for pain. Since cannabis itself was at that time illegal in the US and there had been little or no research on the use of cannabis in managing, controlling and treating pain, few people patient or medical doctors were able to do anything more than simply file the information away where it might be of value someday.
Today, with the legalization of medical cannabis in 28 states, the District of Columbia, Guam and Puerto Rico, the use of medical cannabis is now becoming a significant factor in managing patients with pain of all types and for all reasons.
In a 2014 study, researchers recognized that between 1999 and 2010, those states which had legalized medical marijuana, had on an average nearly 25% fewer opioid overdose deaths each year when measured against those states where cannabis still continued to be illegal.
This was when, possibly for the first time, antidotal stories of meaningful pain relief using medical cannabis could no longer be over looked as serious mechanism by which to control, limit and reduce deaths secondary to overdoses of prescription pain meds, particularly prescription opiates.
How Does Medical Marijuana Work to Manage Pain?
Cannabis relieves pain by making it more bearable, rather than actually reducing it. Over the years researchers have found that people benefit more from using cannabis as a pain reliever because of small changes cannabis creates within their brain. Humans are all born with an Endocannabinoid system and their receptors are found throughout the body. In each tissue, the cannabinoid system performs different tasks, but the goal is a stable internal environment despite fluctuations in the external environment. The compounds in cannabis mimic the natural chemicals that the body produces. Researchers have identified two cannabinoid receptors: CB1, predominantly present in the nervous system, connective tissues, gonads, glands, and organs; and CB2, predominantly found in the immune system and its associated structures. Many tissues contain both CB1 and CB2 receptors, each linked to a different action while THC acts as an antagonist to reduce pain when combined with CBD.
Dr. Michael Lee of Oxford University's Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) recognized that "cannabis does not seem to act like a conventional pain medicine. Some people respond really well, others not at all, or even poorly. 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." Since cannabis does not affect the pain centers of the brain, it does not have the same addictive capabilities as opiates, there for cannabis has a much lower likelihood of addiction.
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