Marijuana Offers Hope For Treating Chronic Pain And Reducing Use Of Other Medications, New Study Shows

Marijuana and its cannabinoid components may be useful treatments for various types of chronic pain, in some cases helping to reduce the use of other medications, according to a newly published scientific review. The paper also says select mixtures of cannabinoids could help minimize undesirable effects of cannabis, such as the psychoactivity of THC.

Published last month in the journal Medical Cannabis and Cannabinoids and authored by researchers at Penn State College of Medicine, the paper reviews “the most recent evidence supporting the use of cannabis in the treatment of chronic pain disorders including chronic neuropathic pain, cancer-induced neuropathic pain, chronic musculoskeletal pain, and chronic headaches and migraines.”

The report concludes that a selection of cannabis compounds, with various effects on chemical receptors in the body, can have a pain-relieving effect. It also recommends further research into the possible analgesic properties of less-common cannabinoids such as cannabichromene (CBC) and cannabigerol (CBG).

All told, more than 180 different cannabinoids have now been isolated from the cannabis plant, the report notes, often interacting with different parts of the body. CBD and THC, for example, “have a wide potential for therapeutic effects based on their multiple molecular targets including ion channels, receptors, transporters and enzymes.”

“The two most abundant and studied cannabinoids, THC and CBD, along with an understudied cannabinoid, cannabigerol (CBG), have been shown, in our laboratories, to reduce neuropathic pain in animal models,” authors wrote, recommending that further study “into cannabinoids like THC, CBD and CBG should focus on the optimal therapeutic doses and the effects these cannabinoids can have on the management of chronic neuropathic pain in humans.”

Chronic pain affects more than 100 million Americans, the review says, and is one of the most common reasons adults seek medical care.

“Chronic neuropathic pain, chronic musculoskeletal pain (back pain), and neurogenic syndromes (migraines) can be debilitating and resistant to treatment,” it continues. “Current treatment approaches are inadequate producing minimal to no relief from pain in many cases or are accompanied by limiting side effects. Cannabinoids can help suppress chronic pain by interacting with cannabinoid receptors in the central nervous system, PNS [peripheral nervous system], and the generalized ECS [endocannabinoid system].”

While marijuana has experienced numerous cultural shifts in its thousands of years of history as a medicinal remedy, its use has increasingly received acceptance and—in medical settings—encouragement in recent decades, authors wrote.

“Most modern research has focused on the phytocannabinoids produced by the plant which have been found to help minimize chronic neuropathic pain and mitigate other disorders including seizure conditions (e.g., Lennox-Gastaut and Dravet syndromes) and spasticity in [multiple sclerosis],” the paper says. “This review has provided scientific evidence supporting the use of cannabis as an adjuvant in the treatment of chronic pain which could also lead pain reduction to the point of minimizing other pharmacological treatments.”

Additionally, it concludes, cannabinoids “can be used in combination to lessen the undesirable side effects or increase the analgesic effects of prescription medications. An example of this is the use of CBD to attenuate the psychoactive effects produced by THC.”

The paper notes in a conflict of interest statement that one author and the Penn State College of Medicine itself receive research support from a state medical marijuana registrant, PA Options for Wellness.

The review is part of a flurry of research in recent years into the use of cannabis to treat chronic pain, which is one of the most common qualifying conditions among patients in many states with medical marijuana programs.

Research published earlier this year in the journal Pain, for example, found that marijuana was “comparatively more effective than prescription medications” for treating chronic pain after a three-month period, and that many patients reduced their use of opioid painkillers while using cannabis.

The analysis “was able to determine, using causal inference techniques, that use of medical marijuana for chronic pain under medical supervision is at least as effective and potentially more effective in relationship to patients with chronic pain treated by prescription medications (nonopioid or opioid),” said the report, by authors at the University of Pittsburgh, Harvard Medical School and the National Cancer Institute.

A separate federally funded study found that legalization of marijuana in U.S. states is associated with reduced prescriptions for opioid pain medications among commercially insured adults—indicating a possible substitution effect where patients are choosing to use cannabis instead of prescription drugs to treat pain.

“These results suggest that substitution of cannabis for traditional pain medications increases as the availability of recreational cannabis increases,” authors of that report wrote, noting that there “appears to be a small shift once recreational cannabis becomes legal, but we see stronger results once users can purchase cannabis at recreational dispensaries.”

“Reductions in opioid prescription fills stemming from recreational cannabis legalization may prevent exposure to opioids in patients with pain,” the paper, published in the journal Cannabis, continues, “and lead to decreases in the number of new opioid users, rates of opioid use disorder, and related harms.”

Other recent research also showed a decline in fatal opioid overdoses in jurisdictions where marijuana was legalized for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. Authors estimated that recreational marijuana legalization “is associated with a decrease of approximately 3.5 deaths per 100,000 individuals.”

“Our findings suggest that broadening recreational marijuana access could help address the opioid epidemic,” that report said. “Previous research largely indicates that marijuana (primarily for medical use) can reduce opioid prescriptions, and we find it may also successfully reduce overdose deaths.”

“Further, this effect increases with earlier implementation of [recreational marijuana legalization],” it added, “indicating this relationship is relatively consistent over time.”

Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. Overall, results of the study indicated that “cannabis has a substantial role to play in pain management and the reduction of opioid use,” it said.

Yet another study, published in 2023, linked medical marijuana use to lower pain levels and reduced dependence on opioids and other prescription medications. And another, published by the American Medical Association (AMA) last February, found that chronic pain patients who received medical marijuana for longer than a month saw significant reductions in prescribed opioids.

About one in three chronic pain patients reported using cannabis as a treatment option, according to a 2023 AMA-published report. Most of that group said they used cannabis as a substitute for other pain medications, including opioids.

Other research published that year found that letting people buy CBD legally significantly reduced opioid prescription rates, leading to 6.6 percent to 8.1 percent fewer opioid prescriptions.

A 2022 research paper that analyzed Medicaid data on prescription drugs, meanwhile, found that legalizing marijuana for adult use was associated with “significant reductions” in the use of prescription drugs for the treatment of multiple conditions.

A 2023 report linked state-level medical marijuana legalization to reduced opioid payouts to doctors—another datapoint suggesting that patients use cannabis as an alternative to prescription drugs when given legal access.

Researchers in another study, published last year, looked at opioid prescription and mortality rates in Oregon, finding that nearby access to retail marijuana moderately reduced opioid prescriptions, though they observed no corresponding drop in opioid-related deaths.

Other recent research also indicates that cannabis may be an effective substitute for opioids in terms of pain management.

A report published recently in the journal BMJ Open, for instance, compared medical marijuana and opioids for chronic non-cancer pain and found that cannabis “may be similarly effective and result in fewer discontinuations than opioids,” potentially offering comparable relief with a lower likelihood of adverse effects.

Separate research published found that more than half (57 percent) of patients with chronic musculoskeletal pain said cannabis was more effective than other analgesic medications, while 40 percent reported reducing their use of other painkillers since they began using marijuana.

In Minnesota, meanwhile, a state government report this year on chronic pain patients enrolled in the state’s medical marijuana program said recently that participants “are finding a noticeable change in pain relief” within a few months of starting cannabis treatment.

The large-scale study of nearly 10,000 patients also shows that nearly a quarter who were taking other pain relievers reduced the use of those drugs after using medical marijuana.

Another new study on the use of medical marijuana by older patients—age 50 and above—concluded that “cannabis seemed to be a safe and effective treatment” for pain and other conditions.

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