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Doctors prescribe marijuana for various conditions. Pain, however,\nremains the number one reason for prescription for almost 91 percent of\nusers across seven states. According to a 2014\npaper\npublished in The Journal of Global Drug Policy, cannabis can alleviate\nboth acute and chronic pain. Acute pain is short-term and lasts only\nuntil the injury is healed, while chronic pain persists for more than\nthree months, such as in cancer and arthritis.

\n

Inadequate Pain Relief

\n

About 38 million adults in America suffer from chronic\npain, and 12\nmillion of them have turned to marijuana for relief, according to an ABC\nNews poll. The usual armamentarium of analgesics for chronic pain--from\nopiates to antidepressants and anticonvulsants--are no longer adequate,\nespecially in intractable cases such as cancer-associated pain and\nneuropathic pain, which is caused by damaged nerves. In a recent patient\nnon-adherence study by\nAmeritox,\nurine samples were collected from patients who were prescribed\nhydrocodone, one of the most frequently prescribed opioids. Of the urine\nsamples that tested positive for marijuana, 36.5 percent showed no\ntraces of the prescribed hydrocodone. \"…the data strongly suggests that\nmarijuana use is associated with an increased...prescription non-drug\nadherence,\" said Harry Leider, MD, Chief Medical Officer of Ameritox.\nThis non-adherence indicates that people who are using cannabis are\nfinding relief from their pain without opioids.

\n

How Cannabis Helps

\n

To equip physicians with better pain management tools, researchers are\ntaking another look at cannabis, which has been used against pain for\nmore than 2,000 years. It has been discovered that the main\ncannabinoids in\nmarijuana, such as THC (delta-9-tetrahydrocannabinol) and CBD\n(cannabidiol), are similarly structured to the body's own\nendocannabinoids (neurotransmitters that produce pain relief). This\nallows THC and CBD to bind to cannabinoid receptors in the body and\nelicit analgesia. The non-psychoactic CBD also helps by reducing nausea,\ndecreasing anxiety, suppressing seizures, and inhibiting the synthesis\nof pro-inflammatory proteins, making marijuana an effective\nanti-inflammatory agent as well.

\n

Cannabinoid receptors are located in different areas of the body, but\nwhen it comes to neuropathic pain, those that are situated in the\nrostral ventromedial medulla (RVM) part of the brain play possibly the\nmost critical role. Scientists in Italy were able to confirm that two\nnon-psychoactive cannabinoids--CBD and cannabichromene\n(CBC)--in marijuana have\nsuccessfully targeted the RVM in rat models. The findings confirm the\nviability of marijuana in treating neuropathic pain induced by cancer,\nHIV infection, alcoholism, diabetes, shingles and amputation, to name\nsome.

\n

On the Right Track

\n

In fact,\nSativex, a new\ncannabis-derived drug that contains equal parts THC and CBD, is already\napproved in Canada for the treatment of neuropathic pain in multiple\nsclerosis and cancer. Its safety and efficacy are demonstrated in\nseveral clinical\ntrials,\nincluding for rheumatoid arthritis. Possible adverse\neffects,\nlike tiredness and dizziness, are noted to be acceptable. Sativex has\nbeen granted Fast Track Designation by the US\nFDA,\nto expedite its development and review for the treatment of advanced\ncancer in patients who experience inadequate relief despite optimized\nopioid therapy.

\n

The recognition of cannabis as a powerful agent in pain management is\nspreading throughout the country. Medical marijuana is already\nlegalized\nin 23 states and in Washington DC, while more than half a dozen are\npending legislation.

\n

Photo Credit.

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