Chronic pain: a guide for patients

Jun 20, 2023

Chronic pain

Endless numbing pain can be a manifestation of dozens of different diseases and conditions. It is commonly encountered in diseases such as multiple sclerosis, cancer, HIV/AIDS, and after injuries, arthritis and other degenerative diseases of the hips, joints and connective tissues, or burns.

Pain is not considered a disease per se, but a symptom that patients often have difficulty managing. Each of us experiences pain with a different intensity, frequency and duration. Depending on the diagnosis given, algesiologists determine how to treat the pain – usually deciding what the nature of the pain is, how severe it is, where it occurs and how long it lasts.

The problem for almost all of us

Chronic pain is a health problem affecting most of the aging population in the civilized world. The available statistics are frightening – in Europe, an estimated one in four adults suffer from some kind of chronic pain.

If chronic pain sufferers want to live life to the full, they need to alleviate it as much as possible while minimising the side effects caused by many common painkillers.

Failure to treat severe or long-term pain can end tragically, as patients find themselves in such a desperate situation that they wish they had died. Because of the excruciating pain, they are often unable to continue with conventional treatments that might otherwise help them, but unfortunately also cause them further suffering. In such cases, anything that can relieve the pain has a chance of prolonging the patient’s life.

Chronic pain

Different mechanisms and forms of administration

Cannabis helps in the treatment of pain in several ways. Alone or in combination with other analgesics, it not only relieves pain, but also suppresses vomiting or nausea that occurs as a result of severe and prolonged pain.

As regards the possible forms of application of cannabis, inhalation of smoke (joint, pipe, etc.) or vapour (vaporiser) can usually provide almost immediate pain relief. The cannabinoids contained in the plant are absorbed more quickly and efficiently into the bloodstream when administered in this way.

In contrast, oral (cannabis edibles, capsules, tinctures, extracts) or rectal (suppositories) consumption has a longer onset of effects, but the duration of effects is longer and often more intense compared to inhalation. At the same time, it is worth bearing in mind that the psychotropic effect may be more intense with higher quantities of THC ingested.

A complex mixture of substances for a complex problem

The interplay of dozens of different cannabinoids, terpenes and other substances in the cannabis plant (over 1 400 have been described to date) may explain why the effects are better when the whole plant and extracts are used than when individual isolated cannabinoids are used – for example, synthetically produced THC, which has been prescribed by doctors around the world for decades under the brand name Marinol. This is called synergy and it is based on the premise that the medicinal effects of certain substances are multiplied when administered together, making them more effective than when administered alone.

Chronic pain - Medical Cannabis treatment

In addition, analgesic effects have been confirmed for a number of substances found in cannabis – in addition to the best known and most frequently mentioned cannabinoids THC and CBD, for example, cannabichromene (CBC), which is the third most abundant cannabinoid in many varieties and has anti-inflammatory and analgesic effects (although weaker than THC).

Combination with other analgesics

Cannabis is increasingly used to treat pain associated with cancer, where the pain tends to be resistant to opioids. In some studies, cannabis has been shown to be as effective as, for example, codeine.

As for the interaction with opioids, which many patients and doctors fear, cannabinoids can act synergistically not only with each other but also with opioid-based drugs. With these drugs, it is not uncommon for a patient to build up a tolerance to them and then for the same doses to be ineffective (with side effects getting worse).

List of common conditions

In conclusion, here are the most common conditions for which cannabis treatment can significantly help chronic pain patients:

● chemotherapy for cancer, especially when accompanied by nausea and anorexia.

● post-operative pain (cannabinoids as an adjunct to opioid treatment suppress nausea and vomiting)

● severe spinal injuries, peripheral neuropathic pain or central pain after stroke

● chronic pain of various origins causing insomnia

● arthritis pain

● HIV/AIDS patients with cachexia, neuropathy or any severe pain

*The above text was written by an independent contributor and does not reflect the official views of Motagon or the guidelines for the use of Motagon products.