Health Bites: Cannabis and Pain

Pain demands change. Everybody has pain at one point or another in their life’s journey. It is a natural part of our human experience. Pain can be an extremely destructive emotion. A terrifying state of being that may produce isolation and exhaustion. So many individuals want to numb themselves to pain by ignoring it, denying it, or masking it. Understandably, reactions to pain do not produce healing, only ensure its continuation, re-emergence, and eventual amplification. Pain always continues to exist somewhere in the complexity of being until it is finally healed.

The Endocannabinoid System (ECS) plays a huge role in keeping our internal processes stable. Yet there is a whole lot we need to learn about it. Experts are developing a better understanding of the Endocannabinoid System that could eventually change the way we are treating a myriad of health conditions.

In humans, the Endocannabinoid System (ECS) also controls energy homeostasis and mainly influences the function of the food intake centres of the central nervous system and gastrointestinal tract activity. The endocannabinoid system regulates not only the central and peripheral mechanisms of food intake, but also lipids synthesis and turnover in the liver and adipose tissue as well as glucose metabolism in muscle cells.

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In recent studies, scientists point to a discovery that the human body contains its own natural
occurring endocannabinoid system. There are natural occurring cannabinoids (external cannabinoids), such as those found in marijuana, they signal cannabinoid receptors to regulate a
wide variety of physiological processes, including but not limited to, the sensation of pain. There
are two types of receptors, cannabinoid receptors 1 and 2 (CB1 and CB2), which employ specific
regulatory functions in the human body.

In the broader context, CB1 receptors are located in the central nervous system (i.e., the brain
and spinal cord), controlling information received by the senses, enabling response reactions and behaviours.

The drugs that act as agonists of CB1 receptors (Dronabinol, Dexanabinol) are currently proposed
for evaluation as drugs to treat neurodegenerative disorders (Alzheimer’s and Parkinson’s diseases), epilepsy, anxiety, and stroke.

It is important to note that CB1 receptors are absent in the part of the brain that regulates heart
and respiratory function (the medulla oblongata). The use of cannabinoids as pain management is far safer than opiates, which may cause damage and death form respiratory deficiencies or arrests. While cannabinoids do not replace opiates’ strong analgesic properties, especially in cases of new trauma or injuries.

However, cannabinoids in conjunction with a reduced number of opiates can produce a synergy
of effective pain control, reducing the risk of adverse effects and the habit-forming potential of
opiates. Delta (9)-THC and morphine may be useful in lower dose combination as an analgesic,
indicated in pre-clinical studies. CB2 receptors cluster in the periphery of the body, especially in tissue involved in proper immune responses. High concentrations of CB2 receptors are housed in the spleen. Hence the engagement of CB2 receptors plays an enormous role in the treatment of chronic pain associated with autoimmune diseases, where the body’s own immune system turns on itself.

Plant based cannabinoids, and numerous other plant-based (non-cannabinoid) constituents, synthetic cannabinoids, and those produced by the human body engage significantly in reducing inflammation. There are many studies (2004 to 2009) that determines cannabinoids effectively relieve pain related to inflammation such as in post-surgery patients, rheumatism, rheumatoid arthritis, chronic neuropathic pain,
and fibromyalgia.

Interestingly to note that cannabinoid found in cannabis is cannabidiol (CBD). Unlike THC, CBD does not make you “high” and typically does not cause any negative effects. Experts are
not exactly sure how CBD interacts with the Endocannabinoid System (ECS). But they do know that it does not bind to CB1 or CB2 receptors the way THC does. Many believe it may work by preventing endocannabinoids from being broken down. This allows them to have more of an effect on your body or that CBD binds to a receptor that has not yet been discovered.

Non-steroidal anti-inflammatory drugs (NSAIDS), opioids possess a myriad of therapeutic applications. Patients in need of pain control, where those concerned about habit forming substances and adverse effects, could benefit from a broader risk benefit analysis, often in cases of pain, as cannabinoids have proven efficacy.

It is important to bear in mind that cannabis too can induce unwanted results. Using cannabis excessively of the subjective therapeutic dosage window can induce adverse effects including an increase in pain, anxiety, paranoia, or irritability.

Is Cannabis safe? The Cannabis plant evokes numerous concerns and questions worthy of examination. The smoking of marijuana and its effect on the lungs is another commonly expressed concern. What about the plant’s impact on the heart or the possible development of cancer? Studies have suggested marijuana may be implicated as a co-factor in developing schizophrenia, or cause traffic accidents from irresponsible use.

Is it possible to overdose on cannabis? Not taking into consideration the social, historical, and political aspects of cannabis. According to international sources, zero deaths were found due to the exclusive use of cannabis (studies 1997 to 2005). The Centre for Disease Control (CDC) estimates that on average, tobacco claimed 111,050 lives annually (from 2000 to 2004). The average alcohol related fatalities estimated at 75,700 in 2001.

Beyond analgesia and the potential to reduce the use of opiates, cannabis reduces painful spasms, diminishes anxieties associated with anticipation of pain, induces rest and sleep. Cannabis can elevate mood, all essential elements to holistic healing.

Analgesic effects of cannabis are time proven and empirically established. Those wishing to use cannabis to reduce pain, should begin with micro dosing at a low dose and work up slowly to determine the most effective, appropriate window. Evidence has shown that most adverse effects are related directly to using cannabis more than the recommended subjective therapeutic window. That means taking too much may increase the very symptoms you attempting to treat, the feeling of apprehension and anxiety may multiply.

When considering the mind, body, medicine and pain; pain gets our attention. Pain saves lives and prevents or minimizes damage. Pain can motivate, inspire and force us to make new choices and avoid the choices that initiated the pain in the first place. Pain makes us aware of where our attention is immediately required.

The worse the pain, the more acute the demand for attention. When the pain receives attention, new choices are quickly implemented. Imagine, incautiously the hand that moves into the fire is quickly removed and the pain immediately stops. This creates a strong memory to be cautious and careful with fire. Pain begins as an emotional reality, when addressed healing takes place in the non-physical theatre, its existence will automatically dissolve.

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Authored By: Wanda J Bruce (Dip.Cs)

References:
Endocannabinoid System: (www.healthline.com); Blesching, PhD- Uwe,1958;v https://pubmed.ncbi.nlm.nih.gov/17369778/