Pain

Advances in modern medicine have allowed us to slow the progression of disease, transform life-threatening conditions into long-term chronic ones, and to survive traumas that would have been fatal a generation ago. While many lives have been saved and/or lengthened, there are also many more people living with chronic pain. Chronic pain is physically different than acute pain, and more likely to lead to a dangerous dependency on opioids.

Pain and Your Endocannabinoid System

Both CB1 and CB2 receptors play a role in the perception of pain, making the cannabinoids that bind to these receptors effective at reducing our perception of pain. [22]

There is increasing evidence suggesting that cannabinoid drugs can enhance the analgesic activity of opioids,and thereby their combined use may reduce the dosages of opioids that chronic pain patients take. [4, 55]

Cannabidiol (CBD) activation at the CB2 receptors seems to account for its anti-inflammatory properties and its influence on pain. [22]

Post-operative pain has not been shown to respond to cannabis, and can actually be intensified by THC. [19, 22]

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Medical Cannabis Guidelines

Delivery methods make a big difference when it comes to onset time (how fast the medicine works) and length of effects. Combining delivery methods can be helpful for patients who need relief quickly, and who also need relief to last. THC has been shown to be helpful with pain management, but it can also cause intoxication. Balancing THC with CBD, which can help with inflammation (a common source of pain), can help mitigate some intoxication.

DOSING STRATEGY

Start low and go slow to avoid uncomfortable intoxication.

Desired Effect

Decrease Eye Damage

Active Compound

THC [20], CBD [20]

Delivery Method

Inhalation, Sublingual
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Desired Effect

Panic Relief

Active Compound

CBD:THC 2:1 Ratio
(Based on clinical observation)

Delivery Method

Pulmonary, Sublingual
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Desired Effect

Anti-Inflammatory

Active Compound

THC [38, 55, 70], THCA [39], CBD [22, 38, 41], 
B-Caryophyllene [54, 55], Myrcene [55]

Delivery Method

Pulmonary, Sublingual, Oral, Topical (localized relief)
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Managing Pain with Cannabis

THC, CBD and beta caryophyllene (a terpene present in cannabis) have all been shown to reduce pain.

What is Harm Reduction?

In the purest sense, harm reduction strategies are efforts to reduce the effects of any harm that comes our way, whether that harm comes from natural causes, such as the inevitable break-down and need for repair of organic matter, or from external causes. such as injury, disease, or well-intentioned medical treatments. 

Dosing Cannabis as Medicine

Medicinal cannabis is unique because dosing is patient-centered, self-titrated, and takes time for patients to find the right dose where therapeutic effects are maximized while adverse effects minimized.

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