Treating Chronic Pain With Medical Marijuana

There has been significant research into the treatment of chronic pain with medical marijuana, especially in individuals that have been resistant to narcotics. THC has been the most effective cannabinoid documented to date for pain management, resulting in a wide variety of strains that have been reported as effective.

Difference between CBD and THC in Medical Marijuana

THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana’s psychological effects. It acts much like the cannabinoid chemicals made naturally by the body, according to the National Institute on Drug Abuse (NIDA).

Cannabinoid receptors are concentrated in certain areas of the brain associated with thinking, memory, pleasure, coordination and time perception. THC attaches to these receptors and activates them and affects a person’s memory, pleasure, movements, thinking, concentration, coordination, and sensory and time perception, according to NIDA.

THC is one of many compounds found in the resin secreted by glands of the marijuana plant. More of these glands are found around the reproductive organs of the plant than on any other area of the plant. Other compounds unique to marijuana, called cannabinoids, are present in this resin. One cannabinoid, CBD is nonpsychoactive, according to the National Center for Biotechnology Information, and actually blocks the high associated with THC.

Cannabidiol or CBD, is the cannabis compound that has significant medical benefits, but does not make people feel “stoned” and can actually counteract the psychoactivity of THC.   CBD does not cause a high, unlike THC. The reason why CBD is non-psychoactive is due to its lack of affinity for CB1 receptors. CB1 receptors are found in high concentrations in the brain, and are the pathways responsible for the psychoactive effects of THC.

CBD and THC levels tend to vary between different strains and varieties of cannabis.  By using selective breeding techniques, we have managed to create varieties with high levels of CBD and THC.

These include the widely available strains of Blue Dream, OG Kush, Grand Daddy Purple, Jack Herer, Bubba Kush and Northern Lights. CBD strains have also been reported by patients as effective for managing pain.

How To Medicate

Cannabinoid treatment for pain management has been delivered via smoked and vaporized cannabis, as well as the oral administration of capsules, edibles, tinctures and mouth sprays. Studies display varying degrees of intervals and dosing, ranging from the smoking of cannabis every 3-5 hours, and the oral administration of THC/CBD extracts. The synthetic cannabinoids sativex and marinol are also known to be effective.

The benefit from smoking as a route of administration is instant action and the ability of the patient to self titrate the dose needed for relief.

Vaporizing or Vaping

If you don’t like the idea of smoke there is the option to vaporize. Vaporization does not use combustion to heat the medicine. Unfortunately there is some confusion out there about vaporizers. There are now hundreds of vaporizers to choose from. There are three basic types: pen, hand-help, and tabletop. The differences are in price, portability and size. Some vaporizers claim to be able to vaporize plant matter (flowers), wax and oils. Some can only do concentrates, some only oil. The most important difference is the method used to heat the medicine. There are basically two methods (with hybrids on the way)- conduction and convection.

True Vaporizing is done by convection, where air is heated, and in turn the hot air turns the medicine a to vapor which is then inhaled. Conduction Vaporizing happens when a hot element (metal plate, or bowl) touches the medicine. The medicine is placed directly in a metal or ceramic bowl or chamber that is heated which then heats the medicine and the smoke is inhaled. This is still combustion, and not truly vaporizing. This is closer to dabbing but with a much cooler heating element.


The benefit from smoking as a route of administration is instant action and the ability of the patient to self titrate the dose needed for relief.

What’s Best for my Lungs?

The cleanest method to inhale medicine is true or convective vaporizing. It is better for your lungs since there is no burning or combustion.


Edibles provide ways to eat or drink your medicine. Many medicated edibles and even bottled drinks are readily available at dispensaries. Be aware that most of the edibles at dispensaries are loaded with sugar and carbs. But basically what the edibles and drinks all contain are canna butter and/or canna oil. You can purchase these or easily make them at home to add to your own baked goods, snacks or even meals (especially if you are avoiding sugar or gluten).


Tinctures are not new. Until cannabis was banned in 1937, tinctures were the primary type of cannabis medicines. Tinctures are essentially alcohol extractions of whole cannabis (usually the flowers and trim leaves).

The best way to use tinctures is sublingually (under the tongue). Titration or dose control is easily achieved by the number of drops a patient places under the tongue where the medicine is rapidly absorbed into the arterial system and is quickly transported to the brain and body. All a patient need do with tincture is use a few drops, wait for the desired medical effects, and either use more or stop as the situation indicates. Tinctures can be flavored for better taste.

The Patient

Utilizing cannabinoid treatment to manage the pain associated with cancer, multiple sclerosis, HIV/AIDS and diabetes is well-documented in patients suffering from these diseases.

A FDA-approved trial that studied the effect of vaporized cannabis on neuropathic pain reported THC, even in doses as low as 1.29%, “provided statistically significant 30% reductions in pain intensity when compared to placebo. Furthermore, a 2013 clinical trial published in Neuropharmacology reported that THC in oral and inhaled form significantly decreased pain sensitivity and increased pain tolerance in healthy subjects exposed to experimental painful stimul

A 2013 article in the Journal of Pain, researchers noted that when vaporized cannabis was added to the daily regimen of morphine and oxycodone in chronic pain sufferers, cannabis appeared to “augment the analgesic effect of opioids.” Authors further concluded that the combination of the two “may allow for opioid treatment at lower doses with fewer side effects.”