Chronic pain is one of the most common reasons for seeking health care in Canada and one in five Canadians live with pain. The Canadian Pain Task Force recently concluded that Canadians don’t have access to a range of adequate or appropriate pain management services and as a result have to find a way to live with the pain.
Historically, humans have used opioids to find pain relief. However, in recent years opioids have gained a reputation that’s led doctors and patients alike to be weary of them. Nevertheless, living with unmanaged pain is simply not an option for a large majority of individuals. Thankfully, there’s another option.
Cannabis has been used for pain relief for millennia. In fact, the oldest recorded use of cannabis, dating back thousands of years, is for pain relief. Research consistently finds that pain relief is the primary condition for which people use cannabis and reaches as high as 80% of medical cannabis users. The National Academy of Sciences, Engineering, and Medicine reported that there was “substantial evidence that cannabis is an effective treatment for chronic pain.” This review of all the available research also found that cannabis was as effective as gabapentin (i.e., widely prescribed pain medication) for neuropathic pain. However, not all pain is created equal. Internationally renowned cannabis scientist, Dr. Ethan Russo, recently stated that “cannabis is unimpressive as an analgesic for acute pain”.
So why is cannabis effective for chronic pain and not acute pain?
Chronic pain differs from acute pain in important ways. Acute pain is a biological and psychological response to injury of tissue or the nervous system. Chronic pain is a highly complex phenomenon, considered a disease state that serves little to no biological purpose. When we injure ourselves, such as in the case of acute pain, we may be less bothered by the pain because we know its origin and expect that it will subside as healing occurs. In chronic pain, there can be an increased unpleasantness and distress associated with the experience of pain.
Pain isn’t simply a physical sensation. The impact of our psychology and emotions on pain is impressive and not to be underappreciated. In fact, when we are distracted or in a better mood our pain hurts less. The emotional (psychological) component of pain is so important that it is included in the definition of pain, which is an unpleasant emotional and sensory experience that is unique to the individual.
There’s a growing body of research looking at the relationship between cannabis use and the emotional component of pain. For some people and some types of pain, cannabis is relieving pain by targeting these emotional components rather than the sensory. Indeed, researchers have studied the brain regions of participants after they’ve used cannabis and discovered that cannabis preferentially targets the affective qualities of pain and reduced the reported unpleasantness, but not intensity of ongoing pain.
This research and the reports from patients suggest that cannabis is making pain less unpleasant and likely helping to take their attention off of the consistent dull aches and pains that one can experience while living with chronic pain. There is evidence that cannabis can relieve some pain in some people and cannabis is particularly effective for the emotional and psychological component of pain.
“Whether cannabis is the best treatment for pain or not, many patients around the world believe that cannabis has helped them with their pain,” say the authors of Cannabis and Pain: A Clinical Review.
Michelle St. Pierre, MA is a PhD Student in Clinical Psychology at the University of British Columbia.