How Effective Is THC Against Chronic Pain?

It’s Q&A Day at 10almonds!

Have a question or a request? We love to hear from you!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

No question/request too big or small 😎

❝Does cannabis have painkilling properties comparable to opiods or is it just a matter of being high and not thinking about the pain?❞

Short answer: no

More useful answer: of course, it’s not really an either/or question—but neither are generally considered to be the case, no.

We say “generally considered”, because the illegality of cannabis in the US for a long time really hampered science, so there’s a lot of research that’s just being done now for the first time, when in an ideal world we’d be a good number of decades further along now. That’s not to say there was no research in the interim; there was, but…

• When the substance is illegal, there is a lot less funding to research its properties (since companies can’t sell it)
• When the substance is illegal and public campaigns are saying it’s dangerous, it’s a lot harder to do big trials with large sample sizes (fewer volunteers, harder to get media to run ads)

Even now, to get large sample sizes it’s necessary to look at larger reviews of smaller trials, to get the numbers together. Take this one for example:

❝25 short-term (1 to 6 months) randomized controlled trials (n = 2303; 64% neuropathic pain) assessed cannabinoids. Oral synthetic/purified high THC-to-CBD (THC only) may slightly reduce and oromucosal, extracted, comparable THC-to-CBD ratio products probably slightly reduce pain severity (pooled differences, −0.78 and −0.54 points, respectively, [0 to 10 scale]), with moderate or large increased dizziness, sedation, and nausea. Among THC-only products, nabilone moderately reduced pain severity but dronabinol did not (pooled differences, −1.59 and −0.23 points, respectively). Low THC-to-CBD interventions may not improve outcomes.❞

Read in full: Cannabis-Based Products for Chronic Pain: An Updated Systematic Review

Translating some of that from sciencese:

• Neuropathic pain is a good one for research, because since the problem is with the nerves themselves, there isn’t also a different causal problem to confound the data
  • If that’s what you have though, do check out: Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
• High THC ratio products “may slightly reduce pain severity” or “probably slightly reduce pain severity” depending on means of administration.
  • That’s very unimpressive
• High THC ratio products do, however, offer “moderate or large increased dizziness, sedation, and nausea”
  • That’s not great either
• Low THC ratio prducts “may not improve outcomes”
  • That is hardly a claim at all
• THC-only prodcuts may or may not moderately reduce pain severity. Only nabilone achieved this, out of the products they tested.
  • That may arguably be the most worthwhile piece of information to come out of this 2,303-person systematic review

Is it worth it?

The science is not exactly a rave review, is it? But the fact is, many people do swear by it. And ultimately, if it works for you, it works for you.

So, whether or not it’s worth it is a personal, subjective decision for several reasons:

1. It may work better or worse for you than for the average person.
2. You may experience more of fewer adverse side effects than the average person.
3. You may experience those adverse side effects more or less strongly than the average person.
4. Pain impairs function. THC also impairs function. Only you can decide which function(s) you’d rather have impaired.
5. You may or may not have other options available, compared to the average person.

We can offer health information here, but not health advice. Not just for legal reasons, but also because we don’t know your individual circumstances.

What we can do is say: consider the options, assess the risks, and get what support you can.

For unravelling some popular confusions with regard to the risks, do see: Cannabis Myths vs Reality

And for CBD-only considerations: CBD Oil: What Does The Science Say?

Want to learn more?

If you’re looking for alternatives, we’ve written quite a bit about pain management, including:

• Before You Reach For That Tylenol…
• How To Stop Pain Spreading
• How To Dial Down Your Pain
• Managing Chronic Pain (Realistically!)
• Get The Right Help For Your Pain
• The 7 Approaches To Pain Management
• Science-Based Alternative Pain Relief (When Painkillers Aren’t Helping, These Things Might)

Take care!