Cannabis as pain medication

Cannabis as a painkiller

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.

Chart showing dopamine levels
What applies to ADHD patients in terms of dopamine levels and THC intake also applies analogously to pain patients. In contrast to healthy people, the level of happiness hormones such as dopamine or serotonin is chronically low in pain patients. When consuming THC this value is not raised to a level at which one feels "high" or "stoned" as is the case with healthy people, but rather depending on the dose it is first raised to the "normal" level at which the chronic pain is reduced or barely noticeable for the patient.

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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Cannabis and ADHD

Cannabis and ADHD

Cannabis is now a miracle cure for a wide variety of diseases and ailments. Which has not scientifically been proven yet, because scientific studies cost a lot of money, but anyways it has already done a lot of good for patients. Cannabis is currently being used against all sorts of things. Against migraines, against back pain, against fibromyalgia or treating the symptoms and comorbidities of ADHD. This article is about those correlations between cannabis use and ADHD.

What is ADHD anyway?

ADHD is not the "fidget syndrome", not a fashion diagnosis, nor is it a personality disorder. Because even, if there is something to the terms - the terms are filled with prejudices and appear disrespectful to patients. The bottom line is that ADHD is nothing more than Attention Deficit Hyperactivity Disorder.

And what can you imagine by that? The site aptly writes:
ADHD is not a disease like measles or mumps, that can be clearly identified or ruled out. ADHD is more like being overweight or having high blood pressure. If you have too much of it, it can become critical.

[This definition is accurate, but I still don't know what ADHD is or how to recognize it. So my best bet is to take a step further towards symptoms to make the matter more tangible.]

ADHD manifests itself in different symptoms, that can appear separately in different people. On one hand, an ADHD patient can be purely hyperactive and impulsive, i.e. restless, fidgety and very talkative. On the other hand, a person affected can also be disturbed in their attention, and frequent dreaming or wandering about an activity is particularly noticeable. This symptom is often misused to call the smartphone-savvy Generation Z “Generation ADHD”. A third group combines the two symptoms and is both disturbed and hyperactive.

There are two kinds

Those affected, who only suffer from concentration or attention disorders, do not have ADHD, depending on the definition, but ADD. An attention deficit disorder. This is often not recognized, because concentration disorders in society are not regarded as illness-related, but rather as a weakness. It is more likely that a person affected, is often just told to try harder or to play less on their smartphone in order to be able to be able to concentrate better. Children in particular suffer from these misjudgments, as they are much less able to assess situations. Often they suffer from categorization and stigmatization and look for the fault in themselves. This often leads to social problems or depression. Therefore my early appeal to all parents out there: If your child is struggling with homework or cannot sit still for a long time - please do not blame them, until a doctor has taken care of the matter. Because only a precise diagnosis can reveal whether the child suffers from ADHD, or simply needs more exercise or retreat.

Now I have talked briefly about children, but one thing should be said: ADHD is not a childhood desease, all age groups suffer from ADHD. While ADHD regresses in some people during puberty, this is often seen as a wrong sign. In many cases, the symptoms simply change; adults affected no longer suffer so much from an unrestrained urge to move, but increasingly from concentration disorders. This often manifests itself in forgetfulness, ignorance or disorganization.

What are the causes of ADHD?

Of course, ADHD cannot be compared with a viral infection or an allergy. So no external influences are responsible for ADHD, right? It's not that simple. Because although ADHD is not "triggered" by pollen or viruses, psychosocial influences can strongly influence ADHD in its development. Family and school, for example, can fundamentally control the development of ADHD. Stress is seen as a major, negative factor. The extent of ADHD is strongly influenced by family disputes or separated parents, but also by low family income, frequent criticism or inconsistent upbringing without rules.

Another criterion that promotes the development of ADHD is pregnancy. Nicotine, alcohol, and other drugs are believed to promote ADHD. However, this is not yet scientifically proven - which does not mean that the concern is unjustified!

According to some studies, hereditary factors are said to have an influence on the development of ADHD. In the case of dizygotic twins for example 30% of the test pairs showed the same symptoms, in the case of identical twins even 80%!

Why does cannabis help against ADHD?

To understand why cannabis helps against ADHD, it is first necessary to understand how ADHD works in the body. Researchers and doctors today agree that ADHD is caused by a disruption in chemical signaling. One study found, that half of the ADHD patients examined, had an abnormality in the neurotransmitters norepinephrine and with dopamine deficiency.
Dopamine deficiency is the key to the healing properties of cannabis, but more on that later.

But why does this deficiency of "happiness hormones" occur in ADHD patients? Scientists still disagree on this. However, many experts assume that ADHD patients develop too many dopamine transporters in certain areas of the brain. This means, that dopamine stored in synaptic fissures is removed more quickly than in healthy peoples brains. This is why a dopamine deficiency occurs.

But not only the dopamine deficiency is a cause, especially since it is not the decisive factor for the syndrome in all ADHD patients. Therefore, some researchers have investigated, why ADHD patients often react differently or in an unusual way to rewards or punishments. So the brain areas where the motivation and reward center is located were examined. It turned out that many of the patients examined, had a particularly low density of dopamine receptors in these areas. In plain terms: There is no dopamine deficiency, there are simply no docking points for the dopamine.
As a result of this anomaly, many downstream functions are also impaired. For example, the lack of attention correlates directly with this fact.

Cannabis raises the level of happiness

So here's where cannabis comes in. In a nutshell, the “happiness level” in ADHD patients is much lower than in healthy people.
This is partly due to the lack of dopamine. It is well known that cannabis can increase this “happiness level”, because dopamine is released through the ingestion of THC. But if you have been paying attention up to now, you will be surprised: Wasn't the problem with the many dopamine transmitters and the low density of dopamine receptors? Right, that's exactly how it is. But cannabis would not be a drug that’s so hyped, if it didn't have a solution for this problem: The endocannabinoid system. Although the presence of this alternative nervous system is not due to the plant itself, it is basically the key to the lock in our body.
The THC is the key, the endocannabinoid system is the lock.

If THC hits the receptors of the endocannabinoid system, a relatively large amount of dopamine is released for the duration of the effect. That's why most cannabis users are pretty happy and "high", when they smoke weed.
However, the ADHD patient first reaches the normal happiness level through the consumption of THC, i.e. the level at which healthy people are sober.

Chart showing dopamine levels of adhd and neurotypical patients
Chart showing dopamine levels of adhd and neurotypical patients

It is obvious, but not yet scientifically researched, that the now restored dopamine balance in the brain can also reduce the consequences of the low dopamine receptor density in the reward center. One study found, that particularly hyperactive and impulsive behavior patterns decreased in patients when using cannabis.

What does the cannabis patient say?

On the Cannabis Normal! Conference I took the opportunity to talk to an ADHD patient. He confirmed the theory about the dopamine level, he also needs cannabis for an acceptable feel-good climate. To get really high, he needs a lot more cannabis than, for example, myself as a neurotypical person.

Another "problem" for him is the large amount of cannabis that he consumes. As a solution, he had delicious wax with him at the conference, which he extracted from the Pedanios 22/1 with a straightening iron. Pharmacy dabs for gourmets! This allows him to take medicine in small doses throughout the day and he does not have to inhale any unnecessary pollutants.
After a long fight with the health insurance, he gets the cannabis paid for by them, so ADHD patients should stand their ground - You have the right for access to your medicine, apart from Ritalin!

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tobacco joint on paper money

Why tobacco joints (biochemically) make no sense at all

The various cannabis cultures around the world are united in their hearts, but devided in consumer culture. Due to different supply markets, one issue in particular separates cannabis users worldwide: Does tobacco belong in the joint or not? Today I would like to take you on a journey through different smoking cultures habits and want to show why tobacco joints in 2021 are simply no longer up-to-date.

Let's start with the current geographical differences in cannabis tobacco consumption

The Atlantic Ocean acts as a natural border between the American “pure joint” and the European “tobacco joint”. Traditionally, massive amounts of cannabis have been produced in Mexico and California for half a century - enough to supply all passionate cannabis users in the North American target markets with sufficient cannabis buds. There is talk of abundance, great competition and thus attractive prices for the end consumer. That is why cannabis is mainly consumed pure in the cannabis hype nations USA and Canada. Cigarettes generally have a hard time in North American societies. Loose tobacco is very rare, and if you get one, it's at exorbitant prices.

The only exception are blunts, cannabis flowers rolled up in tobacco leaves. Blunts are quite common in the US. The tobacco leaves that replace the rolling paper naturally contain nicotine - but in significantly lower amounts than our European friends smoke in their joints.

Dried Tobacco Leaves
Dried Tobacco Leaves (Source)

Tobacco high culture in Europe

And with that we take a look at Europe. On the continent of millennia-old civilization, where the Romans invented dental fillings, Isaac Newton discovered gravity or Michelangelo set David in stone, cannabis is traditionally consumed with tobacco. And ironically tobacco is rarely grown in Europe - it's not supposed to, because tobacco is one of the oldest imported goods and Europe practically invented colonialism.

Smoking cigarettes is also much more widespread in Europe than in North America, as these observations made by some users of the popular expat social network Quora suggest. Also my experiences after living in Germany, Spain and Switzerland show me that much more cigarettes and tobacco are generally smoked in Europe. In Europe, the tobacco in the joint is simply part of common smoking habits. Thus, many consumers like my former blogger colleague Daniel from show with their stories that they often associate a certain love-hate relationship with tobacco. He has written numerous articles entitled "Fuck You Tobacco Joint", in which he repeatedly recounted his efforts to quit smoking tobacco. Again and again setbacks, missed goals and finally the surrender to his nicotine addiction.

Tobacco addiction from cannabis concentrates such as hashish

In my early days as a cannabis patient, I was never a tobacco smoker, but during my time in Spain I discovered my “love” for tobacco. In an environment where good hash dominated the supply market, I couldn't find any other way to medicate cannabis than rolling the hash in joints with flammable tobacco. Before that, I stayed in Germany, where the consumption of tobacco joints was predominant. In Germany, however, mixed with cannabis flowers instead of cannabis hashish.


Anyone who has ever been to Berlin and smoked the Berlin Amnesia Haze knows that cannabis can contain very high levels of active ingredients in Europe. Since cannabis possession is subject to high penalties in Europe, especially in Germany, Sweden or France, there are also very good reasons for highly potent weed or hash. Because for a joint with the same effect you need significantly less of the previously illegal cannabis flowers when they have a high potency than when the active ingredient concentration is low.

This means that only smaller quantities have to be transported and the penalties are lower if you are caught with such less amounts. In order not to be completely overwhelmed by the high levels of active ingredients as a consumer, mixing it with tobacco to «dilute» the THC concentration has established itself as the go-to solution.

But are tobacco joints really the solution for a more pleasant high?

Tobacco joints because "I can't afford to smoke pure weed" = you lie to yourself

Before I emigrated from Germany, I quickly noticed in my cannabis-positive circle of friends that the tobacco in their joint is an insane consumption motor. Tobacco plays mainly the sellers of cannabis products in the cards, because users of tobacco joints consume nicotine. Sooner or later, tobacco joint users develop a nicotine addiction, which the consumer later on associates with the inhalation of cannabinoids. This means that after the joint you just smoked has waned, thanks to the nicotine, the need for the next joint is quickly aroused.

Tobacco joint smokers who do not smoke cigarettes have the highest costs

Because often the craving for the next joint is in truth the longing for the next load of nicotine. Because nicotine, as a very fast-acting neurotoxin, has the potential to trigger an almost immediate effect in the body and head. It ranges from a brief, activating «kick» to a moment of relaxation, depending on the situation. However, this craving for nicotine could also be satisfied with a cigarette, an IQOS or an e-cigarette, which in many cases is a much cheaper option than the next tobacco joint.

I have spoken to many people about this topic lately; Many who have only recently given up tobacco consumption. We all share one observation: At the end of the day, tobacco joint smokers smoke significantly more cannabis than pure smokers. There are several reasons for this.

As this peer-reviewed study shows, for example, regular nicotine consumption inhibits the reward function in our brain when nicotine is withdrawn, i.e. when tobacco is not being smoked.

The decrease in brain reward function experienced during nicotine withdrawal is an essential component of nicotine addiction and a key barrier to abstinence.

As a result, the brain's reward function is only available to a limited extent when a regular tobacco user smokes a pure cannabis joint. Because nicotine, in contrast to THC or other cannabinoids, unfolds its effects very quickly and also subsides very quickly, a large amount of dopamine is briefly released. The THC, which is available for the release of dopamine in the body much longer, can then no longer release sufficient amounts of dopamine, which would be necessary to exceed the reward threshold in the brain.

And if we go back to the above quote, we will, to make matters worse, note that the threshold of reward for nicotine-dependent people in a withdrawal state is also significantly higher than for people without nicotine addiction - so it takes even more reward-promoting substances such as THC to cross the threshold of perceived happiness.

Conclusion: Tobacco should be banned from all cannabis products, even if it boosts cannabis consumption lucratively

Even if the desire for the next joint in connection with tobacco is much higher than when smoking pure joints, this connection should not be exploited by the industry. In Switzerland, for example, there is such a product with the popular "Heimatzigaretten", which contains 20% CBD cannabis flowers and 80% tobacco blends. The consumer is made physically dependent by the product and longs for new tobacco mixed joints to satisfy his cravings.

In terms of the consumers and customers health, pure joints are therefore the comparatively healthier option. Because every time you smoke, with or without tobacco, lots of toxic and carcinogenic substances are released, such as benzene. So if there is already the craving for smoking, smoking should at least be minimized in order to protect health. While CBD, for example, even lowers the pressure of addiction and thus even delays reaching for the next joint, nicotine builds up an unnecessarily high addictive potential.

Of course, from the consumer's point of view, it is very difficult to quit smoking nicotine. However, consuming pure CBD can help in the withdrawal process. In this study, for example, nicotine abandoners who consumed CBD daily smoked 40% fewer cigarettes per day than the control group who did not take any CBD.

The health benefits of stop smoking are huuuge

Those who have successfully given up smoking tobacco can notice physical improvements in themselves within a short period of time. Lung regeneration begins after a month. After 10 years, the chance of dying from fatal lung cancer is already halved. After 20 years, all cells damaged by tobacco consumption have regenerated to such an extent that the risk of death is as low as that of a person who has never smoked in his life. Here's a great list with all improvements after specific time spans.


ps: And for everyone who "cannot afford" to smoke pure cannabis: There are excellent tobacco substitutes or inexpensive CBD flower mixtures for this very purpose; As a substitute for tobacco.