Medical Marijuana and Pain 1

Pain Due to Injury, Neuropathic Pain, and Inflammation


Cannabis is known to work very well for patients with muscle spasms, chronic pain, nausea/anorexia, and other painful symptoms.  Often it works better than more traditional (and harmful) medications like opiates for pain relief.


At Compassionate Telemedicine, our goal is to work with pain doctors to help patients switch from opiates for pain control to medical cannabis, if their underlying conditions meet texas qualifications for low dose THC under the Compassionate Use Act.


Chronic pain affects more than 25% of people in the United States - seventy million adults living with physical restrictions from pain and the emotional stress that comes with that pain.  The psychological effect of living with pain is constant an unrelenting.  This is made worse by the insomnia that accompanies the pain, creating a vicious cycle of pain-anxiety-sleeplessness- and depression. 


Types of Pain


Neuropathic Pain is nerve pain.  This is pain caused by irritation, inflammation, and/or compression of nerves.  It is often described as tingling, shock-like, hot-and-cold, with numbness as well. 


Nociceptive pain is pain due to injury or physical damage.


Inflammatory pain is found in conditions like arthritis where cytokines and chemical messengers over-react and cause acute or localized pain..


In reality, these three types of pain often overlap and don’t present in distinct textbook form.  Cannabinoids provide excellent treatment for all three of these types of pain in a much gentler and less habit-forming way than traditional pharmaceuticals like muscle relaxers or opiates.


Nociceptive Pain - Does Cannabis Work?


The Journal of Pain reported that more than 80% of 1,321 patients questioned reported that they chose to use cannabis instead of traditional pain medications like opiates and benzodiazepines because they had fewer side effects and better symptom management.  Many states like Oklahoma have legalized cannabis to help fight the opiate epidemic precisely because medical marijuana is a more safe and effective way of treating pain without the dangers of opiate addiction. 


For example, one patient in a study was documented to stop taking his opioid medication in less than 36 hours after completion of major shoulder surgery by substituting an oral 2:1 CBD:THC tincture. 


Due to changes in DEA regulations, pain doctors are more and more limited with the opiates they can use for pain.  Usually patients are given tramadol or vicodin, neither of which are as effective as stronger opiates that are discouraged and highly restricted.  It has been my experience that medical marijuana is often far more effective at alleviating pain than these two opiates.  Low dose THC or other CBD-isolated medications can often be substituted at doses of 20 mg of CBD alone.  For more severe pain, THC may need to be added.


Some patients worry about stopping their pain medications suddenly and switching to cannabis.  It is a more effective plan, and more gentle on the body, to slowly taper the opiates down as you increase the dose of CBD and/or THC to control the pain.  When done correctly, the patient can transfer over with almost no side effects or withdrawal at all.  As the opioids are removed, they should be seamlessly replaced by an adequate dosage of CBD and/or THC.  Some patients may have pain that still requires daily opioids, but the dosages should be much lower when combined with cannabis.


For patients with severe pain, or if CBD is simply not strong enough, THC offers synergistic pain relief when combined with CBD..  Based on our patient population at Compassionate Telemedicine, the ratio with the most success for pain relief is 3:1 CBD:THC.  Both of these ratios are available at the two dispensaries located in Texas for TCUP users. 

Patients suffering from daily, chronic pain should not suddenly stop taking their pain medications throughout the day.  It is harder to stop pain once it starts than to prevent pain by consistently taking low dose medication before the pain begins.  Reducing the euphoric effects while treating pain with THC is necessary for patients who require around the clock pain medication.  This means that patients need not be afraid of taking daily doses of medication, while staying at the lowest effective dose possible


If you find that a 2:1 CBD:THC ratio is too strong, try a 3:1 or 4:1 CBD:THC product.  The effective ratio for pain control is different for each patient..  By consistently consuming the same dose of THC around the clock at regular intervals, most people find the side effects of THC become more tolerable.  This is called tolerance, and is not the same thing as addiction.  It is important to treat your pain effectively so that you can have the highest quality of life.  It is always harder to overcome pain than it is to prevent it, so smaller doses around the clock are more effective than large doses taken sporadically.



Dr. Allison Kendrick

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