Katherine Golden, RN and CEO, executive director, and founder of Leaf411, provides a summary on the evidence surrounding cannabis as a treatment for chronic pain patients.
Although more research is needed, several studies have suggested that cannabis may be an effective alternative pain management option for some patients.
Today, one in every five Americans is struggling to manage chronic pain, according to the US Centers for Disease Control (CDC) (1). In addition, the CDC reports that 7.4% of Americans are dealing with chronic pain that frequently limits life or work activities, also known as “high-impact chronic pain.” To combat chronic pain and try to manage its debilitating effects, patients spend billions on opioids and medical procedures every year. But the often-limited success of many procedures and the potential for opioid misuse has patients seeking alternative treatments.
While not approved by the US Food and Drug Administration (FDA), cannabis has become an increasingly popular option for many of these patients—particularly as more states have moved toward legalizing the plant. Licensed practitioners can recommend cannabis as a treatment option in states where medicinal and recreational cannabis has been legalized. However, research on cannabis treatment for chronic pain continues to lag, and many medical professionals possess limited knowledge of cannabis, as well as a lingering reluctance to recommend it for treatment. To help clear up confusion, let’s take a look at what is known—and what is not known—about cannabis as an alternative pain management treatment for chronic pain.
First, if you or someone you know is consuming cannabis to help manage chronic pain, you are far from alone. According to a 2020 study on medical cannabis use in the US, chronic pain was cited as the third most common medical reason patients consumed cannabis (2). This is not surprising, since chronic pain has become the most-often cited reason that US adults seek medical care. An estimated 20% of US adults (approximately 50 million people) reported having chronic pain, with 8% saying the pain restricted or hindered at least one life activity, as reported by the CDC (3). Increasingly, patients are reducing or eliminating their use of pharmaceuticals by adding cannabis to their treatment regimen (4).
But Does Cannabis Really Work?
Although there are large numbers of patients who claim that cannabis has provided relief for their chronic pain (5), the lack of clinical evidence has prompted many medical professionals to believe it is not likely to work for the majority of individuals with chronic pain (6). Still, there are several studies that show cannabis can be an effective treatment, as discussed below.
According to the Cleveland Clinic Journal of Medicine (7), cannabis may be an effective alternative or adjunctive treatment for peripheral neuropathy, an often debilitating condition for which standard treatments often provide little relief. In an article published in 2018, the Cleveland Clinic cites small clinical studies which have found that cannabis provides benefits for peripheral neuropathy, including pain reduction, better sleep, and improved function.
Also in 2018, the American Academy of Neurology (8) reported on a study suggesting that cannabis may provide pain relief by reducing connections between the areas of the brain that process emotions and sensory signals. In the study, researchers found tetrahydrocannabinol (THC) reduces a person’s pain when compared to placebo. On a scale of zero to 100, before taking medication, on average the study participants rated their pain levels at 53. After taking THC oil, participants rated their pain levels at an average of 35 compared to an average of 43 for those who were given the placebo.
In 2022, researchers at the Oregon Health & Science University in Portland announced the conclusion of a study that suggested cannabis may relieve chronic pain (9) as effectively as opioids and other commonly used treatments. Stressing that findings are not conclusive, the researchers cautioned that there are still many unknowns about the potential risks of cannabis and its long-term effects on the body, but they said the study showed that cannabis was at least moderately effective at reducing pain.
As promising as these studies seem, there is no question that the lack of clinical trials and concrete evidence continues to cast the effectiveness of cannabis treatment for chronic pain in doubt. One study from Harvard Medical School, has even suggested that a placebo disguised as cannabis provided similar pain relief to actual cannabis consumption (10). Until comprehensive research can be conducted, it appears there will continue to be debate about just what effect cannabis can have on chronic pain. Yet, as Ted J. Kaptchuk, the Director of the Program in Placebo Studies and The Therapeutic Encounter at Harvard-affiliated Beth Israel Deaconess Medical Center, pointed out about the Harvard study: “With the exception of opioids, most pain-relieving medications are barely better than a placebo.”
Kaptchuk advised patients to check with their healthcare professional before beginning any cannabis treatment for chronic pain. But he concluded, “If something helps relieve your pain and doesn’t cause any significant harm, I would say go ahead and use it.”
Katherine Golden is a registered nurse and CEO, executive director, and founder of Leaf411, a 501(c)(3) nonprofit organization founded in 2019 with a mission to provide education and directional support to the general public about the safe and effective use of cannabis (marijuana and hemp). For more information or to schedule a consultation with a cannabis-certified nurse, call 844-LEAF411 (844-532-3411) or visit leaf411.org.