Medical Marijuana for Chronic Pain Management

According to Harvard University psychiatry professor Dr. Lester Grinspoon, cannabis has been used as medicine and to treat symptoms like pain for more than 5,000 years.

Chronic pain, which persists and sometimes never ceases, is characterized as discomfort that slowly increases over time until it becomes a consistent pain. This is very different from acute pain, which is episodic in nature, features a sudden onset, and results from an accident or injury. Unlike most cases of chronic pain, acute types are treatable with a wide range of drugs and therapies (including cannabis). Chronic pain is sometimes defined as pain that lasts three months or longer, regardless of the cause.

The pain conditions in which cannabinoids have been shown to be most effective are those caused by damage to the nervous system, either peripheral or central. That can include diabetic neuropathy, post-traumatic pain after surgery and HIV-associated neuropathy in the case of the peripheral system, and multiple sclerosis or a spinal cord injury for the central system. Patients report a number of effects from cannabis, including improved sleep and help for their anxiety or stress, as well as a reduction in discomfort.

Studies have also demonstrated that using cannabis for the management of pain is safe. After a year of regular use, patients with chronic pain were found to be at no greater risk of serious adverse effects than non-cannabis users.

Major Components of Cannabis

  • Delta-9 Tetrahydrocannabinol (Delta-9 THC) – It is the main psychoactive component of cannabis with mild to moderate painkilling effects. It also helps treat nausea associated with cancer chemotherapy and to stimulate appetite. It induces feelings of euphoria. Potential side effects include accelerated heartbeat, panic, confusion, anxiety and possible paranoia.
  • Cannabidiol (CBD) – It is a major, non-psychoactive component of cannabis that helps shrink inflammation and reduce pain without inducing the euphoria effects of THC. It has been used to treat rheumatoid arthritis, inflammatory bowel diseases, psychotic disorders and epilepsy. Larger amounts of CBD can relax the mind and body without causing negative side effects associated with THC.
  • Cannabinol (CBN) – It is a secondary psychoactive component of cannabis. It is not associated with painkilling effects of THC or CBD. CBN is formed as THC ages. Unlike the euphoria effects of THC, CBN can induce headaches and a sense of lethargy.
  • Tetrahydrocannabivarin (THCV) – It is found primarily in strains of African and Asian cannabis. THCV heightens the intensity of THC effects and the speed in which the component is delivered but also causes the sense of euphoria to end sooner.

A study conducted in 2014 and published in the Canadian Urological Association Journal found that nearly half of the participants, all of whom suffered chronic prostatitis/chronic pelvic pain syndrome, reported using cannabis in an effort to reduce their pain. The study found that 61 percent of those who used medical marijuana to treat pain “reported improvement in symptoms as a result of use.”

It is estimated that chronic neuropathic pain affects more than one in five adults. Two most powerful therapeutic applications of cannabis are as an analgesic (pain reliever) and in the role of an anti-inflammatory. Because inflammation often leads to pain, cannabis medicine works on multiple levels to provide relief to many patients. Unfortunately, chronic pain is often unaffected by conventional medical treatments or pharmaceutical drugs. This is the major reason that so many patients seek out cannabis medicine — often without a doctor’s recommendation.


  • Marihuana as MedicineA Plea for Reconsideration, Lester Grinspoon, MD; James B. Bakalar, JD
  • UCSF Study Finds Medical Marijuana Could Help Patients Reduce Pain with Opiates, Leland Kim
  • A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome, Dean A. Tripp, PhD, J. Curtis Nickel, MD, FRCSC, et al.

Cannascribe is one of Canada’s longest standing services assisting medical patients in obtaining safe and legal prescription marijuana.

Diane Filipe