According to the most recent data published by the CDC, 20.4% of US adults suffer from chronic pain and 7.4% suffer from high-impact chronic pain (the type of pain that frequently limits daily life or work activities). Considering those numbers, it comes as no surprise that chronic pain is the most common cause of long-term disability in this country, accounting for an estimated $560 billion dollars in direct medical care costs, disability programs and lost productivity.
As a multifaceted illness that takes not only a physical but also an emotional and mental toll, the treatment of chronic pain requires an equally multifaceted approach where experts in different specialities like psychiatrists, physical therapists, psychologists, neurologists and pain management physicians team-up to provide a comprehensive treatment plan for their patients. When chronic pain becomes too much and traditional medicine lacks efficacy, more and more Americans turn to medical marijuana. Why use medical cannabis to treat chronic pain? Find the answer below!
Let’s start with the basics: What is chronic pain? Chronic pain is long standing pain that persists for over 3 months or occurs alongside a chronic condition such as arthritis, spasticity or fibromyalgia (among others). It interferes with daily activities, can lead to other conditions such as depression, anxiety, fatigue or trouble sleeping and is one of the main causes of long-term disability in the US.
Given that chronic pain is usually accompanied by other issues, pain management physicians need to identify and treat both the cause of the pain and any accompanying illnesses. This explains why patients are often prescribed not only pain medication (corticosteroids, muscle relaxers, nonsteroidal anti-inflammatory drugs or opioids) but also other medicines or therapies in order to address accompanying conditions such as insomnia or depression.
Medical marijuana can help treat chronic pain thanks to the cannabinoids CBD and THC present in the plant that can interact with the human body’s endocannabinoid system. In a nutshell, cannabinoids can produce analgesic effects by activating different receptors in the body. Initial studies attributed such effects to CBD’s and THC’s connection to CB1 and CB2 endocannabinoid system receptors which play a key role in the body’s pain regulation, chronic pain regulation and the slowing down of chronic inflammatory processes (among other functions). More recent studies have determined that cannabinoids act on multiple pain targets within the central nervous system and peripheral nervous system. By interacting with many other receptors like GPCRs, PPARs and TRP channels, cannabinoids’ beneficial scope goes beyond the connection to the receptors that were initially identified. These findings explain why medical marijuanas benefit so many patients’ healing journey and they also provide the basis for multiple opportunities to develop new medicines with improved efficacy and limited side effects for the treatment of pain in the human body.
When chronic pain becomes too much and traditional medicine fails to provide effective results for pain management or presents intolerable side effects, more and more Americans opt for exploring other available alternatives; cannabis is one of those alternatives. In fact, empirical evidence shows that medical marijuana is effective for pain management, offering fewer side effects and an improved quality of life for patients.
It is important to make a distinction between medical cannabis and regular weed. Although cannabinoids are found in both, only by following treatment with medical marijuana can patients ensure that they are using the adequate marijuana strain as well as the exact ratio of CBD to THC that will be effective for their specific condition. Also, only by using medical cannabis under a registered health care provider and dispensed by a licensed dispensary can patients ensure the quality, purity and access reliability to their medicine, as well as medical follow-up and support which are key for a successful outcome of their treatment.
With growing concerns about the opioid crisis in America and the approval of medical marijuana programs in many different states, 3 in 10 chronic pain patients are turning to medical cannabis because of its beneficial analgesic effects; also, more and more experts are taking a close look at the use of medical marijuana as an alternative to other treatment options and in particular as a substitute for opioid-based pain medication.
A common conclusion is that a majority of patients have been able to reduce the use of opioid and non-opioid medication when using cannabis to treat chronic pain, many of which expressed that they would prefer to completely replace opioids if they had open access to medical marijuana as a treatment option. The reduction of opioid use could translate into lower accidental overdose fatalities and reduced opioid-related admissions to treatment centers.
Texas approved the use of medical marijuana for qualifying conditions through the Texas Compassionate Use Program (TCUP) in 2015. The program has evolved over the years, expanding the list of qualifying conditions to include -but not limited to- several incurable illnesses such as epilepsy, MS and PTSD; unfortunately, chronic pain is not included in the list as of January 2023 (for a comprehensive list of qualifying conditions click here).
This is in contrast to medical cannabis programs in other states such as Minnesota where chronic pain was added as a qualifying condition in 2020. At the time, the Minnesota Commissioner of Health Jan Malcolm explained that “the generally positive experience patients have had using medical cannabis to treat intractable pain prompted us to add chronic pain as a qualifying condition” and also added that “the bottom line is that people suffering from [this condition] may be helped by participating in the program, and we felt it was important to give them the opportunity to seek that relief”.
Although in Texas chronic pain is not included in the TCUP, it can be associated with qualifying conditions such as fibromyalgia, muscular spasticity, neuropathy and cancer (just to name a few). In those cases, patients can be eligible to be included in the Compassionate Use Registry of Texas (CURT) by a registered provider and medical marijuana can be dispensed by any of the licensed Texas dispensaries to address chronic pain as a symptom of another underlying health condition that is approved within the program.
The team at Texas Cannabis Clinic led by Dr. Brimberry is a proponent of the expansion of the TCUP in the current legislative session to include “all access” to the program. In that scenario, patient eligibility would rely on their doctor’s discretion as to whether medical cannabis could aid in their healing journey rather than relying on a restricted list of qualifying conditions. If the all access proposal is not adopted, our practice will advocate for the expansion of the program to include chronic pain in the existing list of qualifying conditions to mirror what other states like Minnesota are already doing in their own programs.
You can help by getting involved and joining our advocacy efforts to reach that goal, urging your legislators to support adding more medical conditions to the Texas Compassionate Use Program.
If you suffer from a qualified condition and experience chronic pain we can help you find relief. If you suffer from chronic pain and are unsure whether your comprehensive health condition makes you eligible for the TCUP program, contact us! We can help you find the answer.