Swapping poppies for chronic

Study: Use pot, not pills, to treat pain

Doctor hand holding bud of medical cannabis and pills

More than 51 million people in the U.S. suffered from chronic pain in 2021, according to the Center for Disease Control (CDC). In some cases, the condition is the result of an injury or prior health issue; in some cases, it’s associated with psychological distress or trauma. 

In either case, the official recommendation of the CDC is that doctors avoid prescribing opioids to chronic pain patients. Because they’re so addictive, can be deadly and negatively affect people’s mental health, the CDC says opioids should never be “first-line” forms of therapy for chronic pain patients.

New research might suggest that cannabis could be a legitimate alternative to opioids for chronic pain patients. In fact, the study, published in the Journal of Cannabis Research in November 2023, not only found cannabis to be “equally efficacious” as opioids at mitigating pain intensity in patients with chronic pain, it also found that cannabis helped improve patient’s sleep, focus and emotional wellbeing.

“The results of the present study support the hypothesis that the effects of [cannabis] on pain experience are more holistic than those of opioids,” the study’s conclusion states. 

Researchers wanted to see how cannabis compared to opioids when used for pain management among chronic pain patients. Led by Jussi Jylkkä, a professor of psychology at Åbo Akademi University in Turku, nine researchers examined a sample of 201 chronic pain patients: 40 used medical cannabis to treat their pain, and 161 used opioids. There was some crossover among the samples. Roughly 45% of the cannabis patients also used opioids for their pain, and about 4.3% of opioid users also used medical cannabis.

Following the study, participants completed retrospective surveys on the positive and negative “phenomenological effects” of the medicine. The researchers then compared the scores between the two groups and analyzed them. 

They found that cannabis had an equally potent effect on managing chronic pain as opioids and that it also improved other aspects of the patient’s well-being. Long-term opioid use is commonly associated with sleeplessness and insomnia, anxiety and depression. Cannabis is used to treat and improve those issues. This research highlights why. 

“[Cannabis] may alleviate pain through affecting a broad range of pain-related experiential factors such as relaxation, improved sleep and mood, being able not to react to the pain as well as a sense of control,” the conclusion reads. “These holistic effects of [cannabis] could explain the inconsistencies in clinical trials, where focus has mainly been on pain intensity instead of broader pain phenomenology.”

There were also no indications that cannabis distorted users’ cognitive processes. Despite its holistic effects on consciousness, cannabis was perceived to improve memory, focus and clarity of thought — which could have contributed to the subjects’ feelings of relief. 

The authors note that while neither cannabis nor opioids are first-line treatments for chronic pain, both are commonly used when other treatments fail to provide sufficient pain relief. 

At least in the U.S., the reason the CDC recommends against prescribing opioids for chronic pain has to do with their addictive qualities and the current opioid crisis, which is claiming the lives of over 80,000 Americans every year. Just in Colorado, there were 1,289 opioid overdose deaths in 2021, which accounted for 68% of all drug overdose deaths in the state that year. 

Conversely, the reason cannabis isn’t widely prescribed to treat chronic pain is because of its federal prohibition, even though it is a naturally occurring, non-addictive medicine that is all but impossible to overdose on. 

According to these findings, cannabis could potentially act as an alternative treatment for chronic pain patients. For those who haven’t found current treatments effective or who don’t want to take prescription medications to manage it, cannabis could be an effective alternative, or a supplement to other treatments, one that’s equally effective as opioids. 

“In sum,” the authors concluded, “the results lend support to the notion that the psychoactive effects of [cannabis] are relevant to its therapeutic effect on pain, in line with suggestions in previous literature.”