This study only looked at 250 people who already have medical cannabis prescriptions for pain, so this shouldn't be extrapolated too heavily.
I don't think that one can appreciate how effective it is for chronic pain, until you've had to use it for that.
Very annoying that the body do this. If you could figure out a drug that prevents this you could make billions!
For example and something everyone can try: My body is addicted to coffee. If I don't take it for a few days I'll become very tired, headaches, etc. It's lasts for about two weeks. While addicted I don't abuse it. I've even switched to tea a few times.
Moreover, my pain is neuropathic, rather than physiological in nature, and so what works for me, may not work for other forms of pain. That said, I had the best effect managing pain with high CBD low THC strains - meaning strains with over 7% CBD and one percent or less THC. For me, the pain relief is so profound and quick acting that I can pinpoint the second it starts to have an effect, and it has the added benefit of leaving me sober enough that I can go about my business.
Unfortunately, while I found CBD strains most effective for pain, I personally have not been able to tolerate them - they cause me memory problems that I have not found any mention of in the literature, not anyone else who experiences them.
So, what do I use, when I need to keep the pain at bay? Usually I reach for a concentrate of a indica-dominant hybrid, or an pure indica. I stay way from Sour Diesels, and the like, as they don't agree with me, but these things tend to be individual in nature.
Sorry not to be much more help: all I can really recommend is low THC/high CBD strains, and smoking/vaping concentrates or hashish rather than eating, at least until you find something that works for you.
However,
What I actually recommend, and has helped for many of people, is the Phoenix tears/ Rick Simpson oil regiment.
You can buy premade oil marketed as such or Rick Simpson provides diy on how to do this yourself.
Essentially it is ingesting small amounts of concentrated cannabis oil daily, like taking a prescription.
It vastly helped my mom's Chrons and I know of a few people help with chronic back pain
Eating cannabis has very different effects to smoking it, due to liver metabolism. I am not sure what it does to CBD, but the psychoactive metabolite of THC does not have the same effects. Eating cannabis is more than just a different delivery method - it's essentially a different drug entirely.
Unfortunately, while I found CBD strains most effective for pain, I personally have not been able to tolerate them - they cause me memory problems that I have not found any mention of in the literature, not anyone else who experiences them.
It's important to note that, unlike opioids, cannabis doesn't make the sensation of pain less strong, it makes it less urgent.
This means that if you won't necessarily feel a direct effect on the pain, but that its subsequent effects aren't as strong - the pain is not as exhausting, distracting, or debilitating.
Combine this with other therapy methods and you have rid yourself of pain, or at least rid yourself of the holds it has it over you.
Your comment reads condescending to me: "my pain is all in my head." But it's not, and treating my mental heath is treating the symptoms and not the cause. The best thing for my mental health would be an end to my physical pain.
People offering mental health treatment are not saying the pain is "all in your head"[1]. They're saying you deserve treatment for all your problems, not just a focus on one specific pain problem.
We've known for sometime that treatment for mental illness is more effective if it looks at more than the patient's mental illness - if it looks at all the biological, psychological, and social factors.
This concept is moving into physical health treatment, especially for long term pain.
And it seems that mental health treatment can reduce the amount of pain that people feel.
[1] I'm not sure if you realise just how dismissive this sounds. Mental illness is debilitating and one of the top ten causes of years lost to disability. Those people aren't "making it up", which is the implication many will draw from your "all in my head" comment.
(Although personally I think while mental health is a large component of chronic pain management I'd say the pain management itself is still the primary issue at hand)
People can handle some pain, and that is fine. 100% pain relief through opiates vs 50% pain relief through less detrimental means is probably worth it.
Although, I suppose the side effects of pot are considered desirable by many.
What are those? Beyond the physical addiction, which shouldn't be much of an issue with proper dosage.
But for the pure side effects, the most common issues are constipation and nausea. Then there's sedation (which may be comparable to effects of pot), and of course the suppressed breathing which makes accidental overdoses potentially deadly, unlike pot. Especially for chronic pain management, the long term effects add up, then you also risk liver damage, etc.
https://www.ncbi.nlm.nih.gov/pubmed/18443635 is a good place to start if you're interested in details.
A few queries resulted in this, which is pretty informative as far as cannabioid treatments go. You're right, the benefits and potency aren't very clear cut, but, unlike opioids, THC-based treatments can produce desirable side benefits, which result in overall better outcomes (if we treat patient satisfaction as a major factor)
Taking opioids for pain relief is a dangerous route as doctors are now more likely to cut your Rx off if they suspect abuse. IF you are addicted and/or still have significant pain, you may have to resort to street drugs with unknown potency and purity.
I'd rather go with the medication that won't lead down a life-threatening path. If the treatment is worse then the symptoms, it's not really worth it.
> Lucas suggests the main reasons for the switch to cannabis from prescribed meds is due to reduced side effects, better symptom management and a feeling that cannabis is safer than prescription drugs.
Also, looking at http://www.webmd.com/pain-management/guide/understanding-pai..., it seems like chronic pain doesn't necessarily (?) mean severe pain, but maybe I'm wrong about that.
When I think of cannabis, I view it as safer. You don't hear about overdoes like you do with opioids. Add in a few famous celebrity deaths like Prince you quickly get a public image that views opioids with suspicion. In my opinion rightly so. Hopefully medical marijuana can be more accessible to more people sooner.
In tests with cannabis, patients reported improvements with both mobility and the amount of pain/discomfort. However, when researchers measured the spasticity there was no clinical improvement. Both were true - it seems sometimes all folks need to do is not be so bothered by their daily pains.
So my guess is people with long term pain are probably better off with canibis long term even if Opiods work really well for post operation pain for example.
I say this after having had a C6-C7 spine fusion surgery -- prior to that, the pain was incredible. And two or three years ago I couldn't have even imagined what that kind of pain felt like, until I was actually suffering it. Luckily surgery was incredibly effective, and I hated having to take pain pills (made it difficult to work), but the pre-op alternative (living with constant pain) wasn't very great.
I certainly didn't want to sit in a hospital just to be able to move around a bit -- and I couldn't have immediate surgery, though I did have surgery as soon as I was allowed to (primarily due to insurance).
I'm sure there are people out there with far worse pain, and in many cases likely untreatable causes. Putting all of those people in the hospital certainly isn't going to help with insurance prices, nor is it a particularly humane way to treat people in the general sense.