Everyone’s different. We all have our own unique bodies and physiology. Some people have bigger bodies, some people have smaller bodies, some people have different bone density in their joints, or other unique physical attributes. We respond to pain differently. We all experience pain differently.
Pain is a constant in our lives, both in health and in illness. For many patients, pain medicine is the only way to manage their pain. But how can we get the most effective treatment from our options? Unfortunately, in many cases, the choice of individual pain medicine isn’t made based on their benefits, and the top choice of pain medicine isn’t always the most effective form of treatment.
Chronic pain is one of the most common medical complaints that patients face. Pain is something that some of us have to live with every day and it can cause tremendous discomfort and distress. There are a number of medications that can help control the pain, but many people find these can be too addictive, too harsh or just not effective.. Read more about best strains for pain and fatigue and let us know what you think.
The number of states where cannabis is legal, both for medical and recreational use, has increased significantly in recent years. However, many doctors still reject the use of cannabis to treat various conditions – and for good reasons.
One group, the International Association for the Study of Pain (IASP), issued a statement in February 2021: Currently there is insufficient high quality clinical evidence of safety and efficacy in humans for the IASP to endorse the general use of cannabis and cannabinoids for the treatment of pain.
To better understand why the IASP made this statement and what the group expects in the future, we spoke with psychologist Judith Sheman, PhD.
Who are the IASPs and what have they done?
The IASP has more than 7,000 pain specialists in 125 countries and is the leading organization of pain specialists in the world. IASP is very interested in finding the best and safest way to help patients manage their pain, says Dr. Sheman.
As the availability of cannabis has increased as a result of efforts to legalize it, the IASP has recognized the need for an assessment of the risks and benefits of its use for pain management. A systematic review of cannabis and cannabinoids is particularly important in light of the opioid epidemic of recent decades.
In 2018, the organization established a working group on cannabis and pain. A year later, in 2019, this task force commissioned a series of evaluations: One focused on previous studies showing the possible harmful effects of cannabis use and the other on randomized controlled trials of cannabis use.
The results of these reviews and their comments were published in the March 2021 issue of PAIN, the monthly journal of the IASP.
What has the IASP discovered?
The IASP took a detailed and methodological approach to its work, particularly given the abundance of anecdotal evidence that cannabis can help patients manage pain. Referring to the pharmaceutical companies fueling the opioid crisis and the trauma caused by the resulting addiction, Dr. Sheman states: The pain community is well aware that no recommendations should be made on the basis of statements by people who may have other motives.
With this systematic approach to research and analysis of studies, Dr. Sheman said, the IASP has tried to look at everything that has been considered regarding cannabis and pain. They wanted to see what was out there. What does science tell us? And if you’re recommending a product for chronic use, you want to know if it’s effective over several years.
They investigated a number of different areas because they wanted to learn more about the basic science and clinical pharmacology of cannabis, says Dr. Sheman. She notes that the group found numerous publications showing that cannabis can be an analgesic (a drug that relieves pain). They also found evidence in laboratory studies that cannabis and cannabinoids may be effective in pain management from a biochemical standpoint.
The problem, notes Dr. Sheman, is that when they looked at clinical trial data, they concluded that the available data was of insufficient quality. There may be confusion among the public because there are many articles about the possible connection between the two, based on anecdotal evidence, she says.
Challenges in cannabis and cannabinoid research
One of the reasons why some clinical trial data is inadequate for the application of the IAP is the so-called placebo factor. It is also called the placebo effect and refers to the number of study participants who report an improvement in their condition when given a placebo and not the drug or treatment being tested. In drug research, the percentage of placebos can be as high as 30 to 40 percent, Dr. Sheman said. Such a high value strongly distorts the results.
The other reason why more research is not being done on cannabis is also obvious. While dozens of states have legalized cannabis for medical purposes, far fewer have legalized it for recreational use. And at the federal level, cannabis is still classified as a controlled substance.
Because of these regulatory barriers, the number of studies available for analysis is much smaller than for other potential treatments. Then again, Dr. Sheman says, there’s a difference between lab-tested cannabis and the cannabis you can buy at a dispensary in one of the states where it’s legal.
There are not many studies, most are of low quality and they do not give clear results. The evidence in these studies is of low quality, she says. The IASP therefore concludes that the available evidence neither supports nor refutes the idea that cannabis can treat pain. At some point that may be useful, but right now we don’t have that evidence.
Concern about possible harm from cannabis use
While there is still much to learn about the potential benefits of cannabis, researchers should also be careful about reporting potential risks. We know that heavy drug use can lead to cognitive problems in adolescents, notes Dr. Sheman.
Other risks identified by the researchers point to a possible negative relationship between cannabis and mental illness, and cannabis and episodes of psychosis. There is also a risk of addiction and, as Dr Sheman notes, it is necessary to clarify how cannabis use affects performance and judgment.
Another complicating factor, she adds, is that we still do not have conclusive evidence about who in the general population is exposed to these adverse effects and what other factors might be involved in these risks.
If you take all these things into account, you get an IASP statement, she notes. There are just too many unknowns.
Amounts: further research
The IASP continues to explore how cannabis and cannabinoids can help patients manage their pain. Anecdotal stories and politically motivated moves to legalize marijuana for medical and recreational purposes only confuse the public.
For the IASP, Dr. Sheman said, it’s about doing more research and keeping up with the data to make the most informed decision based on the science. If the medical community wants to recommend something, it should be empirically based, she says. That means that the data and the science should show that, as far as we know, this information is correct and accurate, and that this is what we need to do to treat people best. We can – and will – change our approach when the science shows results. But there must be results.
While some research is conducted in the United States, other research conducted by IASP goes international, particularly in countries where cannabis is legal at the federal level.
Although the use of cannabis, particularly for medicinal purposes, is currently gaining social acceptance, the scientific evidence remains inconclusive. The evidence just isn’t there yet, says Dr. Sheman. This does not mean that we will not get there, just that we are not there yet.There is no shortage of evidence that cannabis can help relieve pain, but pain doctors are still hesitant to recommend cannabis to patients in part because of the lack of a quality, evidence-based scientific study.. Read more about cbd edibles for pain management and let us know what you think.
Frequently Asked Questions
Does medical cannabis help chronic pain?
There is limited evidence that medical cannabis may be effective for chronic pain. Medical cannabis is not currently approved by the FDA for the treatment of chronic pain. Medical cannabis may help with chronic pain in some patients, but the evidence is mixed. Medical cannabis may help with chronic pain in some patients, but the evidence is mixed. Medical cannabis may help with chronic pain in some patients, but the evidence is mixed. Medical cannabis may help with chronic pain in some patients, but
Does cannabis work as a painkiller?
Cannabis has been shown to work well for pain relief. It works by binding to the cannabinoid receptors in the brain and body. These receptors are found in high concentrations in areas of the brain that control the perception of pain. There is evidence that cannabis can help with pain relief by increasing the release of endorphins, the body’s natural pain-relieving chemical. How Cannabis has been shown to work well for pain
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