The prevalence of chronic pain reported among Canadians over the age of 18 is between 15 – 29%, with approximately 50% of those suffering for over 10 years1,2. Lower back pain is the most common type of pain, and arthritis the most common cause1. While considerable research has been conducted on the effects of cannabis on pain management, the greatest number of human clinical trials have focused on chronic non-cancer pain (CNCP), with a majority reporting a significantly greater reduction in pain (30% reduction) with cannabis use3,4.
Examples of CNCP include:
Cannabinoids, such as THC, act on cannabinoid receptors that are located throughout the body and are involved in relaying and processing sensory information from painful stimuli 8. Animal studies have shown that activation of cannabinoid receptors following a painful event has analgesic properties (e.g., neuropathic pain, inflammatory pain)7,9. While it is still unclear how exactly cannabinoids can lead to a reduction in pain, research suggests that their effects involve both CB1 and CB2 receptors, with some actions being tied to modulation of inflammatory responses7. More research involving placebo-controlled clinical trials are needed, however, to understand the actions and efficacy of cannabis/cannabinoids for treating chronic non-cancer pain.
Opiates are among the most commonly prescribed medicines to combat chronic non-cancer pain, however they are also associated with high abuse and potential for overdosing5,6. There is growing evidence that suggests cannabis may serve as a substitute for opiates in the treatment of chronic pain, and that when used in combination, provides greater relief then either treatment alone, thereby allowing for a reduction in the amount of opiates required7.
Given the evidence that cannabis may be an effective alternative to opioids, which have greater risk for abuse, cannabis may be useful as an adjunct treatment for reducing certain types chronic non-cancer pain. As with all medications, patients considering cannabis as a treatment for chronic pain should first speak to a health care practitioner to determine the options that are right for them and an appropriate treatment plan.