What are the biggest myths about cannabis and pain relief? In the current cannabis space you have two dueling schools of belief: marijuana/ THC V Hemp/CBD. There are those who only swear by THC and there are those who only swear by CBD. The truth is that separately they are not as effective as they are in unison.
This is whats referred to as the entourage effect. Initially this was speculation but new research has been supporting this notion more and more. What is the truth about each? Both THC and CBD are Cannabinoids that have analgesic (pain relieving) properties. We’ve come to accept that THC has stronger analgesic properties than CBD with several synthetic formulations of THC that are approved in the US and internationally for that use (Nabilone, Sativex). But CBD also has analgesic properties although possibly through different mechanisms.
How THC Relieves Pain
THC works through agonism of cannabinoid receptors. These receptors are of two main type: CB1 and CB2 (CB= cannabinoid).
CB1 receptors are found in nervous tissue while CB2 receptors are predominately found in immune tissue. With regards to modulation of pain, CB1 receptors are involved in inhibition of pain signals from the peripheral and central nervous system as well as as interpretation of those signals in the brain. These receptors are also involved in inhibiting signals from nociceptors (a type of cellular receptor specifically involved in pain signaling).
CB2 receptors impact pain perception through modulation of the immune response which causes inflammation. In addition, cannabinoids have also been shown to agonize mu opioid receptors which are responsible for providing pain relief.
How CBD Relieves Pain
CBD exhibits effects by a) antagonizing an enzyme responsible for the cellular re-uptake of cannabinoids. Therefore, CBD increases the efficacy of your endogenous cannabinoids. CBD also bids to the non cannabinoid serotonin and vanniloid receptors while have analgesia action- thereby providing pain relief from a different mechanism than THC.
In combination, a compound containing both THC and CBD will provide multiple mechanisms by which you provide pain relief.
What the Limitations Are
A major limitation is the potential for cognitive impairment. When compared to other non-narcotic pain relievers, THC products can present the side effect of feeling “high.” This can be undesirable in helping to manage chronic pain conditions as it may negatively impact the patients ability to effectively tend to their daily activities.
Other unwanted side effects can include xerostoma (dry mouth), increased appetite/ weight gain, lethargy or lack of motivation, paranoia and there is also a risk of developing dependency (cannabis use disorder).