Cannabis For Pain: An In-Depth Analysis

Cannabis For Pain: An In-Depth Analysis

Note to the readers:

This is a three-part essay. The first part establishes the socio-political context for medical cannabis and new Endocannabinoid research. The second part is scientific. It introduces a new concept, the Endocannabinoidome. The third essay will provide the reader with practical advice on cultivars known to relieve pain. It will also include starting dosing protocols so readers can see if medicinal cannabis is for them.


Part 2

THE PATH TO THE ENDOCANNABINOIDOME

Cannabis For Pain

When a body is in pain, it will send signals to the brain until a remedy is found. In America, the go-to treatment for pain is usually a pharmaceutical. Since 2019, there has been a significant decrease in the dispensing rates of opioids, but there are still hotspots in America where opioids are easy to get. Despite the evidence, they do way more harm than good in the treatment of chronic pain.

Learn about The reality of Big Pharma in detail

Unlike the deadly opioid epidemic of the early and mid-2000s, Cannabis Sativa (cannabis) is centuries-old. It’s easily cultivated and distributed through local channels and is less addictive than most other pain relief treatments. Yes, you can become addicted to cannabis, but according to associate professor of psychiatry at Harvard Medical School and director of the Division of Addiction Psychiatry at Beth Israel Deaconess Medical Center, Kevin Hill, most people don’t.

The pandemic is giving rise to a new opioid problem consequently its been a rise in deadly drug overdoses from illegally manufactured fentanyl. The need for a safe widely accessible pain cure in the US is imperative. Cannabis perfectly fulfills this need.

Plant Co-Evolution

The cannabis plant has a co-evolutionary path with the human body thus explaining the known effects on its users. This is not unlike the hereditary effect catnip has on 50% of all felines. Genetics has half of all cats sensitive to catnip. Humans and cats–hardwired for happy plants! Who knew?

These known “effects” of cannabis—medical treatment and management– are explained by the Endocannabinoid System/ Endocannabinoidome concepts.

So Just How Does Cannabis Relieve Pain?

The human body contains millions of receptors reacting to pain, consequently making pain notoriously difficult to research. But this we know: existing pain research and the science of phytocannabinoids, as well as the ECS and its primary signaling molecules, the endocannabinoids, are all intertwined via the human body’s many and various cannabis receptor targets.

After cannabis consumption, neurotransmitting cannabinoids provide several biological actions. One of which is pain relief as well as a diminished perception of pain. Cannabis also reduces the number of pain signals the body sends to the brain.

New Frontier Data’s 2018 Cannabis Consumer Survey states “42% of all cannabis users, not just medical consumers, use cannabis to manage pain”. Indeed, pain management is one of the most widely cited reasons why American adults consume cannabis today.

The compatibility between the human body and cannabis molecules (extracted from the trichomes on the cannabis flower) is a major scientific breakthrough. That begins with the discovery THC molecules create the psychotropic effects cannabis is most known for:

“The psychoactive component of the cannabis resin and flowers, delta9-tetrahydrocannabinol (THC), was first isolated in 1964. And at least 70 other structurally related ‘phytocannabinoid’ compounds have since been identified. The serendipitous identification of a G-protein-coupled cannabinoid receptor at which THC is active in the brain heralded an explosion in cannabinoid research.”

How Scientists Explain THC Euphoria

The timeline toward today’s comprehensive view of cannabinoid complementarity begins with THC’s discovery in 1964. In 1973, scientists published on the human brain’s opiate receptor. And by 1988 it was reported that the “mammalian brain has receptor sites that respond to compounds found in cannabis.”

In 1990, the profound finding of just how receptive the human body is to phytocannabinoids warranted the naming of a new physiological system, the Endocannabinoid System (ECS). The ECS was discovered by L.A Matsuda, a government researcher for the National Institute of Mental Health, who team-led the research into this new bodily system as well as all its neurological cannabinoid targets.

Upon discovery, they describe a (heretofore) “unknown molecular signaling system within the body. Which is involved in regulating a broad range of biological functions”.

I have always thought that if this bodily system didn’t have anything to do with cannabis, it would have been heralded as a Nobel Prize-winning discovery. Read on to find out why!

Homeostasis

ECS research clarifies just how much THC complements and augments homeostatic regulation in our bodies. Homeostasis is the biological and neurochemical effort to keep molecules and systems in balance, to clarify, it wards off disease.

Um, hello medical community, the ECS exerts its homeostatic regulatory actions in the brain, skin, digestive tract, liver, cardiovascular system, genitourinary function, and bone. (Russo, 2016). He forgot to say reproductive system.

Got Pain? Cannabis And The ECS To The Rescue!

The neuro-processing of noxious stimuli is called nociception. The ECS modulates nociception and reception via neurotransmitter signal pathways. Cannabis helps the ECS reach the goal of pain relief. Ingestion of THC is medically successful when pathways receive the plants’ cannabinoid effects. Which work on the nervous system just as our naturally occurring endocannabinoids do.

The ECS absorbs THC molecules interacting with ECS G-protein cannabinoid receptors to induce widespread effects. Ingested cannabis impacts our bodies in several ways, including significant central and peripheral nervous system functions: memory; food/sexual appetite; mood; and pain sensation are all implicated here.

The primary cannabinoid receptors CB1R and CB2R are expressed literally throughout our entire bodies. They are part of the G-protein coupled receptor family discovered in the “explosion” of research following THC’s discovery. G-proteins respond to signaling molecules and ligands and they respond to the environment.

CB1R expresses throughout the body in the local tissue systems, including skeletal, GI tract, neurological, liver, cardiovascular, and reproductive systems. The other dominant receptor, CB2R, expresses largely in immunity and anti-inflammation. But less in the: “cardiovascular system, GI tract, liver, adipose tissue, bone, and reproductive system.”

A complex combination of mediating cannabinoid chemicals (like Anandamide and 2-Arachidonoylglycerol (2-AG)) and enzymes heal or alleviate the ill, disturbed, or diseased body by facilitating homeostatic balance, as neurotransmitters bind with nervous system receptors via Anandamide and @-AG chemical agents.

Adding THC

The brain positively responds to THC ingestion by mobilizing specific cannabinoid receptors. One analogy here is THC knocking on the brain’s many doors. If the door is not designed to open for THC, then it stays shut. This is an important discovery because it reveals the brain’s pathways are not inimical to THC as a “foreign stimulant”. It also shows how the body is wired to THC’s positive medical interventions. Some pathway doors simply don’t open because they were not designed to open: but others do open. Naturally!

This important receptor function suggests cannabis’ Phyto-molecular compatibility on a deeper level than previous science understood.

The human brain has physiological compatibility with cannabis’ chemical makeup, constituting cannabis’ widespread medical status. (This can also support recreational use as preventative medicine, as well.)

Marijuana’s Help For Pain Management

On the cannabis cultivation side, CBR1/ CBR2 receptor research impacts the ability to tailor for distinctive cannabis cultivars. Treatment of pain is included in the industry’s specific medical application target groups: including pain patients. Medical marijuana pain management evolves in relation to the growing body of research on specific receptor impacts.

A study on Cannabis for pain

The difference between, say CBR1 and CBR2 receptors, matters. For example, in one study, CBR1 reports mixed results regarding therapeutic interventions because of its “unwanted effects”. CBR2 reports more therapeutic “safe targeting” intervention successes.

Marijuana impacts people differently because of the varying cannabis phytochemical properties. As well as neurological diversity itself, including diseases, disorders, genetic predispositions, etc. This difference could be interpreted as a strength, as cannabis’ psychoactive properties in THC can prove a short order compared to long term pain management and health benefits.

Research On Cannabis For Pain

The decades-old discovery of ECS, and its physiological mobilization towards healing and balance, provides a critical research focus in ongoing cannabis pain management research.

More recent research uncovers an even broader ECS– called the “Endocannabinoidome”. In 2015, Vincenzo Di Marzo and Jenny Wang released Endocannabinoidome: the world of endocannabinoidomes and related mediators. Di Marzo here describes the Endocannabinoidome, The endocannabinoid (eCB) system encompasses the eCBs anandamide and 2-arachidonoylglycerol, their anabolic/catabolic enzymes, and the cannabinoid CB1 and CB2 receptors. Its expansion to include several eCB-like lipid mediators, their metabolic enzymes, and their molecular targets, forms the endocannabinoidome (eCBome).”

Described as a “complex signaling system.. deeply involved in the onset, progress, and symptoms of major neuropsychiatric disorders,” eCB research into the neuropsychiatric as physiologically interactive with non-psychiatric events accomplishes several tasks. It illuminates mind/ body healing pathways, it favors medical decriminalization, and even (more controversially) it views recreational use as medically preventative against future psychiatric and non-psychiatric challenges.

COVID-19’s anxiety-producing pandemic conditions did not cause a cannabis industry sales decline. Marijuana’s financial staying power reflects a 38% sales increase to reach $19.7 billion in 2020 sales.

Speaking of anxiety, another important area of cannabinoid research is insomnia/ anxiety treatment, to be considered in the next article here.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481537/

https://www.labroots.com/trending/cannabis-sciences/8456/endocannabinoid-system-discovered

https://www.dialogues-cns.org/dialoguesclinneurosci-22-259/

https://www.globenewswire.com/news-release/2020/09/23/2098004/0/en/Global-Cannabis-Sales-Grow-38-to-Reach-19-7-Billion-in-2020-Despite-Pandemic.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827842/

https://www.humanesociety.org/resources/crazy-catnip

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Maureen Smyth

FOUNDER, SMYTH MED

Maureen Smyth, BSN, RN and cannabis educator teaches virtual cannabis medicine classes for dispensaries, consumers, healthcare providers and various 501c3 organizations.

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