There’s something tricky and beautiful with topics like wine and coffee: it’s easy to argue they’re “bad” because too much of it can be bad, some compounds are better than others (resveratrol > alcohol, antioxidants > caffeine), and they’re often consumed in adulterated packages (latte??).
The same goes for pot (marijuana), just with the added complexity of legal landmines. Whether marijuana for pain relief is a worthy toke or snake oil depends on the filter (no pun intended): are we talking about moderate dosages, the right compounds (THC vs CBD vs particulates), the right package (smoking vs vaporizing vs juicing), the right places of residence?
First let’s get one big monkey of misunderstanding off of our backs. The compound in marijuana that’s been extensively studied for pain relief is not THC but cannabidiol (CBD). In fact there have been 926 medical studies on CBD, most of which have been positive (1). A recent UCSF study found that CBD even has a synergistic effect with opiates, so if you take CBD with opiates, you may need lower dosages of opiates to get pain and anti-inflammatory relief (3).
Pain Relief Without The High
The other cool thing about CBD (or maybe not so cool, depending on how young or how desperately you seek enhanced versions of the real world): it gives you the pain relief of marijuana without giving you a high. THC does have some painkilling, nausea-suppressing, appetite-stimulating qualities but it comes with a host of potential side effects like accelerated heartbeat, panic, confusion, anxiety and possible paranoia (3). The nausea-suppressing & appetite-stimulating qualities make THC a more suitable palliative treatment during chemotherapy, but for pain and other autoimmune conditions, CBD may make more sense.
But That Was My Excuse To Get Baked!
Hey I’m no high police, so if you really wanna get high I won’t stop you. But are you sure you want more pain? Sorry to be a bong-bubble burster, but do a quick google of “pain+smoking+marijuana” and you’ll see the results actually cuts both ways. Here are just a few ancedotes of increased pain from smoking:
“What happens when I smoke is that the soreness and stiffness in my wrists that I associate with inflamed tendons returns” http://ask.metafilter.com/205661/My-wrists-hurt-again-because-I-got-high
“Over the last 12 months or so I’ve had fairly mild hip and pelvis pain, however when I smoke the pain increases ten fold and will last for a good half hour before returning to normal. http://www.bluelight.ru/vb/archive/index.php/t-579241.html
Moderation Helps Pain
One possible cause of increased pain is dosage:
“Smoking high dose increases pain, whereas moderate dose helps: The results are an important addition to research on the pain-relieving potential of cannabis …Although the researchers were surprised at the delayed analgesic effect of cannabis, the increase in pain with high-dose cannabis is consistent with earlier studies.” (8)
Vaporize Away The Undesirables
Vaporizing has become a popular alternative to smoking because it gives you the bioactive compounds without the undesirable by-products:
“Vapor ideally contains virtually zero particulate matter or tar, and significantly lower concentrations of noxious gases such as carbon monoxide ” (4).
The same person above that developed pain from smoking said:
“I agree that using other (routes of administration) for marijuana help immensely. Even switching to a vaporizer may eliminate much of this, it sure did for me! http://www.bluelight.ru/vb/archive/index.php/t-579241.html
Studies have shown that vaporizing delivers a comparable amount of THC as smoking since the it doesn’t vaporize until the heat gets to 300.7 °F, and the vaporizer never has to get that hot since the undesired crap vaporizes at a lower temperature (4). You can reason that the increase in pain from smoking can also be due to smoking too much of crap besides THC and CBD.
Interestingly, CBD requires an even higher temperature to vaporize (403.3°F) so if you only want CBD, you could theoretically get it by heating marijuana to above 300.7°F.
Drinking Pot Juice? Quick, Before Mercola Starts Selling Pot-Masticating Juicers!
You have to admit: PJ has a nice ring to it. Add a banana and you’ll start spazzing whenever your teenage kids start asking for PB&J at school. Seriously though, this may be the best route of administration yet because juicing the whole marijuana plant is much more wholesome than vaporizing it to 350°F since you retain all the natural enzymes. What about the THC you ask? Answer:
“Dr. Courtney explains that heating marijuana destroys enzymes and excites the THC’s psychoactive effects. But if ingested raw the CBD takes over, and dramatic healing activity occurs without the high” (5).
Even better, it’s cheaper than vaporizing because you juice the leaves, not the expensive bud, and these leaves are commonly thrown out by marijuana dispensaries.
Currently, there’s only one approved drug in Sativex that has CBD. Although it also contains THC, what’s promising is that it’s approved as a pain treatment: “Treatment of neuropathic pain and spasticity in patients with Multiple Sclerosis (MS); Analgesic treatment in adult patients with advanced cancer who experience moderate to severe pain” (6).
A clinical trial for CBD treatment in Inflammatory Bowel Disease is currently in phase I recruitment (7). Hopefully we’ll see more studies on CBD-only drugs soon.