Every Tuesday we want to put the medical effectiveness of cannabis to the test in this series.
Each week a different disease or group of diseases should take center stage.Today we are going to explain the context of cannabis and (chronic) pain.

Cannabis has been used to treat pain for thousands of years.
The wonder herb was used early on, especially against migraines, gout, nerve pain, toothache and of course menstrual cramps.
The mechanisms of action of the cannabis plant regarding pain therapy have been researched very well. I am emphasizing this, because the facts are still very thin for many other complaints.
In order to delineate exactly how cannabis helps against pain, I would first like to clarify the term pain.

What is pain?

Pain is a complex sensory perception that sends signals to the human brain like a message: My dear friend, there is something wrong with you.
However, if the pain is chronic, the feeling of pain is not due to a temporary disruption of the human organism. Rather in such cases there is damage to the nervous system. In plain terms, the body sends false signals, false alarms. Chronic pain is a disease of its own.
The pain we feel is conducted through our body via the nervous system. In concrete terms this means: If you bump your little toe the nerve cells on the little toe are irritated. This creates a signal that is sent to the next nerve cells as quickly as possible. At some point this signal arrives in the spinal cord or brain and a neural reaction follows through which we perceive the pain.
Fun Fact: The speed of nerve transmission is not infinitely fast. If we assume 10 m / s, the transmission takes 200 ms (a fifth of a second) for a 2-meter man like me.

But pain doesn’t just make you feel uncomfortable. In the case of chronic pain in particular socio-psychological damage is also often caused. In other words: This affects the quality of life in public spaces, as the person affected suffers so-called breakthrough pain. This can be imagined in bursts of pain attacks or other body malfunctions, for example skin problems.

In the traditional sense, chronic pain is treated with opioids, like morphine, codeine, fentanyl or methadone. Antidepressants are also used in certain cases, if the cause of the pain can be located therein.

Pain treatment with cannabis

Cannabis can be used for most pain relief. The exact processes in the body are incredibly diverse, because pain can arise in many ways. However, there are a number of substances in the body that reduce the sensation of pain. Some neurotransmitters (you can read a bit about them here) can more or less alleviate the pain that is felt. THC for example is such a neurotransmitter and an externally supplied one, aswell. When THC docks onto the so-called receptors (I’ll refer you back here), messenger substances such as dopamine are released.

Dopamine is a essential substance for the feeling of happiness in the body. If the dopamine level is high, pain is felt less intensely. Happiness and pain are therefore directly related – whoever is happy doesn’t perceive much pain. Those who are unhappy feel pain more strongly. The body cannot differentiate between physical and psychological pain.

Other neurotransmitters (messenger substances of the nervous system) are also released when THC is ingested. In this way, effects on the so-called serotonin level can be measured. Serotonin is responsible for stabilizing the psyche and is significantly involved in the body’s own pain inhibition.

So, from a biochemical point of view, consuming cannabis containing THC when you are in pain makes perfect sense. But what do the studies say?

Studies support these considerations. In one trial patients suffering from severe spasticity due to a spinal cord injury were given 5 mg THC, 50 mg codeine or a placebo. As expected, the placebo did not change the condition, the codeine, an opiate, alleviated the spasticity somewhat, and the THC led to significant relief.

In another study, a pain patient was given 30 mg of morphine per day. At some point, 10mg of a THC / CBD extract were added. The pain intensity was measured for both cases over a period of six weeks.
Result: During the period in which the patient received the THC / CBD extract, his need for morphine had decreased significantly with the same pain relief.
Further studies show the effectiveness of cannabis compared to placebos. It has even been proven that THC can reduce so-called phantom pain after amputations.

If you suffer from pain yourself and are now rolling a joint euphorically, here is another tip: The pain is best suppressed the longer the THC works. However since the high wears off very quickly when you smoke I recommend baking a cake or realizing a recipe of your choice. You can read about how to decarboxylate cannabis, i.e. make it “digestible”, in this article.

Which strains are the best, when used for pain relief?

First I have to say, that I’m not a doctor, I therefore advise all readers to always discuss the medication with a doctor. In general, however, you can at least classify which varieties are more suitable for pain relief than others. In many cases, a cannabis patient with pain suffers from chronic pain, which is why continuous medication to alleviate the symptoms is the usual choice. And if you have to start medication early, I recommend a sativa variety for the time until the afternoon or evening. Because with these varieties you can still pursue a lot of activities while the felt pain is significantly inhibited. In many cases sativas are creative, lift the mood and produce a head-heavy high. If the high feeling gets too much for you I recommend taking CBD at the same time, because CBD significantly weakens the psychoactive effects of THC. For some, being high in certain situations can also be exhausting and lead to additional stress in the long run.

For the evening I recommend an indica, because after consuming such flowers you sleep well and enjoy a very physical high. This effect is also often expressed in the well-known “couch-lock”. You feel particularly comfortable in bed or on the sofa and can sleep well all night.

Which varieties specifically? First of all, a multitude of strains and products can help against pain. Because it depends above all on the presence of the active ingredients THC and CBD. In the end I decided on the following sativa-dominant and indica-dominant varieties:
For the day, I recommend a classic: Silver Haze.
With a sativa content of 80% and a high THC content, this strain will get you through the day well.
For the evening I recommend another classic: Skunk.
This strain is listed as 80% indica and pushes you into bed really nicely when you want to sleep.

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