Cannabis in pain therapy?

Cannabis pain therapy accounts for a large share of prescribed cannabis treatments. But how exactly does cannabis help with pain? And for which types of pain does the hemp plant actually make sense? We’ve summarized the most important information for you.

Areas of Application for Medical Cannabis in Pain Management

Since 2017, doctors throughout Germany have been allowed to prescribe medical cannabis. The active compounds in the cannabis plant (cannabinoids) can help when conventional treatments fail or cause severe side effects. Medical cannabis can then be administered as sprays, drops, or by vaporizing the flowers. Treatment with the hemp plant is especially recommended for the following three conditions:

• Spasticity (persistent muscle spasms) in multiple sclerosis
• Loss of appetite, nausea, and vomiting as a result of chemotherapy
• Chronic nerve pain (neuropathic pain)

However, the list of potential applications goes further. In many cases, more detailed research and studies are still lacking regarding the effectiveness of the cannabis plant in other medical conditions.

Cannabis for Pain Therapy

A nationwide survey conducted during the introduction of medical cannabis in Germany found that 76.4% of cannabis prescriptions were issued under the diagnosis of “chronic pain.” Cannabis is often used for pain relief when chronically ill patients can no longer tolerate standard painkillers or when these medications lose their effectiveness. Cannabis is most effective for nerve pain that originates in the nervous system. Especially for older individuals with chronic pain, cannabis in the form of drops can be helpful, as it tends to cause less damage to the liver and kidneys compared to other medications.

Because medical cannabis affects each person differently, the dosage is kept low at the beginning of pain therapy and gradually increased. This allows the optimal dose to be determined for maximum effect while avoiding unwanted side effects.

Does Cannabis Also Work for Acute Pain?

If medical cannabis helps with chronic pain, why is it rarely used for treating acute pain? There are several reasons for this. In general, there are already various ways to manage acute pain. These include conventional painkillers, local anesthesia, or depending on the cause, cold, heat, or pressure. Multiple studies have shown no significant difference between cannabis therapy and placebo in treating acute pain. Cannabinoids appear to be less responsive to acute and tissue-related pain.

Cannabis for Chronic Pain – Why Does It Work?

The effectiveness of cannabis pain therapy, particularly for chronically ill patients, is due to several factors: On the one hand, it has been shown that cannabinoids affect not so much the intensity of pain, but rather the perception of pain. Chronic pain often leads to stress and psychological effects due to ongoing, pain-related limitations in daily life. Medical cannabis can help by reducing stress levels, which in turn lowers pain perception. The pain doesn’t disappear but can be experienced as less severe. Cannabis contains the cannabinoids THC and CBD, with THC providing pain relief and CBD offering anti-anxiety and relaxing effects. Together with other cannabinoids and terpenes (plant-based aromatic compounds), the effects of these substances can be further enhanced (the so-called entourage effect). In the context of chronic pain, this is a valuable combination to improve patients’ quality of life. For instance, better sleep or a more relaxed mood can help make everyday life feel less centered around pain.

To ensure optimal use and dosing of medical cannabis for pain therapy, more long-term studies are still needed. However, existing results already highlight the potential and promise of cannabis-based pain therapy as an effective and lasting treatment option.