Cannabis extract found to be effective for lower back pain
newscientist.com
newscientist.com
That's not very good considering this meta-analysis[0] found that exercise had a mean difference of "−7.9 (−13.6 to −2.2)" compared to placebo for chronic low back pain. ...and the authors say that is a small effect.
In my experience, I find that it depends on the 'type/cause' of the pain. For soft-tissue related I find it helpful, while for hard-tissue related it does not.
Here are my anecdotes.
I've got 3 different types of back problems. (a) deteriorating cartilage between vertebrae causes bone-on-bone grinding -Cannabis does not help with that
(b) muscle spasms in 'other parts' of back from another cause. -Cannabis does help
(c) neuropathy -Cannabis helps quiet the nerves too
IMHO b & c are related, it's a sedative-like effect. AND related to the points in TFA; it helps me to sleep when B & C are active.
Cannabinoids bind to https://en.wikipedia.org/wiki/G_protein-coupled_receptor at a minimum, which exist in every tissue of the body, and of which there are at least a half dozen varieties, probably more. Ancient humans all the way to modern growers have bred plants to achieve specific desirable effects beyond intoxication, in a tight feedback loop, testing against their own physiology.
Cannabis isn't a single drug, it's a factory for a complex family of metabolically related phytohormones.
Then there’s 2018 farm bill cannabis…
THCA, THCP, THC-D9, THC-D8, CBD, etc.
I use it for pain as well but started using it for creativity during college. It’s never presented a problem other than having the feeling of fuzzy teeth (brushing after eliminates this).
My friends that use alcohol all have issues from consuming it where as I don’t have any issues with my liver or anything.
The issue is the stigma and propaganda has been so strong for 120 years that people have forgotten it was one of the first medicines.
I decided to look up the gene regulatory network of the pancreatic islet cells involved in manufacturing insulin. Sure enough, smack in the middle, a G-protein-coupled receptor. The Mythbusters "PLAUSIBLE" sequence played in my mind.
I'm of the opinion that we should probably be paying special attention to any substance with known activity on human cell signalling pathways. Cannabis is capable of targeting so many, spread across such a variety of organ systems, that it seems obviously useful. Wild how we've avoided studying all but the least useful strains.
What I am saying is, I've had chronic pain for a long time. Side effect of skateboarding injuries, snowboarding injuries, a one-wheel injury, sailing injuries. I've broken dozens of bones. Etc etc. Cannabis is the only thing that consistently alleviates the pain. Not saying it's not damaging, it totally is. The inside of your lungs, if smoked for long periods, turns into tar pits. It can cause COPD, among other smoking related issues.
However, I do think that legalizing it here in the US opens up the doors for further research and medicinal advancements. So I'm all for that. However, keeping laws around operating a vehicle, heavy machinery, etc should still stand. I think those that dismiss it are closed minded and those that fully embrace it without protection from side effects or long term use issues are also closed minded. There's some sort of healthy medium I'm sure of. Edibles or topicals.
This is exactly the reason it's often a less than ideal solution. When you need a safe, reliable, and predictable medication, you don't want something that interacts with every cell in the body. Let alone something that might be interacting with those cells in multiple conflicting ways.
Don't get me wrong, if it helps you and doesnt negatively impact your health I'm in favor of it. However, it would be nice to see more research done to develop synthetics and extracts that work in a more targeted, predictable, and well understood manor.
Reportedly, pure THC as administered to cancer patients to treat nausea results in much less favorable results than the compounds naturally produced by plants selectively bred for the purpose.
This is why I pointed to the tight feedback loop between plant and grower. Evolution, coupled with a good fitness function, outperforms most other methods available to us on hard problems. Targeting specific receptors for therapeutic benefit certainly qualifies as one.
Your own quote. It literally inetarcts with every system of the body. Seldom do we need or want that in a therapeutic drug.
How a molecule binds to specific receptors can operate as a targeting mechanism in and of itself. And can also be modified by other molecules produced by the same plant.
Synthetics also permeate and interact with the entire body, typically, btw.
Imagine you went to a doctor with a headache and he handed you 120 pills then said "None of these are labelled, but 15 of these will help with your headache, 60 will do random things to other parts of your body, 20 will cause negative side effects, 3 will make your headache worse, and 13 will get you a little high."
Would you take the lot of them or ask him to do a bit more research and get back to you? To me, it depends how bad that headache is. Either way, I'd hope they start labeling those pills sooner rather than later.
In the case of the plant, selectivity breeding it to have a little more or a little less of each isn't really addressing the root problem that there are hundreds of drugs in there and I only really want the ones that meet my current needs.
> Synthetics also permeate and interact with the entire body, typically, btw.
I mean... Some do, sometimes, I guess? Most have pretty specific mechanisms of action that are understood before we prescribe them.
Don't look up the number of sugars or proteins.
> Imagine you went to a doctor with a headache and he handed you 120 pills then said "None of these are labelled, but 15 of these will help with your headache, 60 will do random things to other parts of your body, 20 will cause negative side effects, 3 will make your headache worse, and 13 will get you a little high."
This is a lovely straw man, but not representative of the situation under discussion. Humans have cultivated cannabis for greater than 5,000 years, longer than many domesticated foods, which are similarly chemically complex. Do you trust the farmer that that carrot is going to have the desired effect if you eat it? Cannabis cultivars carry a similar level of confidence in suitability for purpose.
> selectivity breeding it to have a little more or a little less of each
Oh sweet summer child, selective breeding is so much more complicated than you seem to understand.
> Most have pretty specific mechanisms of action that are understood before we prescribe them.
Throughout most of human history, most drugs have been discovered empirically without any understanding of how they function at all. Having worked with molecular biologists, I'd say it's an enormous stretch to say we understand much about how we work. No comprehensive model exists, outside of testing on real humans, for evaluating the effects of a drug.
I'm really not sure what our disagreement here really is. I think we're both agreed that modern Cannabis is fairly fit for it's purpose. As you say, they've been doing 'human experimentation' with it for thousands of years and it's evolved alongside us. I just also think that we shouldn't halt progress at the level of farming a plant because it's "good enough." We have new tools available to us now, and we should use them.
To try and rephrase: All I'm really saying here is that we should try to understand HOW those cultivars work, and optimize by extracting the useful bits or by synthesizing variations on them in a lab. That way we can minimize the side-effects and maximize the benefits. Are you opposed to that? If so why?
It also seems to me that there is an implicit bias in your comments favoring modern pharmaceuticals over plant-based medicines, which I think is unwarranted. The organisms around us are far more sophisticated than any human construction, our senses are incredibly finely tuned sensors, and selective breeding is an enormously powerful tool. Because these were available to ancient humans, people often make the mistake of thinking them simplistic, outdated, or somehow superseded by modern technology. Nothing could be further from the truth.
From my perspective, a green leafy plant which manufactures a useful compound is a more sophisticated and desirable tool than a fume belching chemical factory making same.
It is no accident that plants an animals around us produce compounds which are useful to us. We are all genetic relatives. Until we understand our own biology fully, and that of the plants and animals upon which we depend, I believe there is much it can teach us.
One thing I've learned is that biology rarely works with pure chemicals. There are always metabolites, precursors, enzymes, enantiomers, and other chemical variations. Sometimes (often?) these prove important as well.
That's a fair criticism. I'm an engineer not just by training, but by nature. When the only tool you have is an engineer, every problem looks like it can be solved with better engineering. So far in life that's mostly worked out well for me.
> One thing I've learned is that biology rarely works with pure chemicals. There are always metabolites, precursors, enzymes, enantiomers, and other chemical variations. Sometimes (often?) these prove important as well.
Similarly, it seems to me that you may be unfairly biased against man made solutions. The problems you describe are just engineering challenges. Difficult ones to be sure, but we have some very clever scientists and some very sophisticated tools that are improving at a non-linear pace. We may not crack the nut this week, but someone will eventually.
> From my perspective, a green leafy plant which manufactures a useful compound is a more sophisticated and desirable tool than a fume belching chemical factory making same.
Plants are also technology now. Why not a genetically modified plant that produces only the desired cannabanoids, or modified versions of the cannabanoids?
I'm being a bit tongue in cheek here, but what I mean to say is that the comparison is a bit unfair. Not every plant is good for you and not every man-made solution is the cartoon chemical plant from Captain Planet. Cannabis as it exists is good for many things, but it can certainly still be improved.
I am also an engineer. But I've spent a decade working with biologists, mathematicians, physicists, and chemists understanding and repurposing evolutionary algorithms. For complex tasks such as these, they are often our best tools.
> Similarly, it seems to me that you may be unfairly biased against man made solutions. The problems you describe are just engineering challenges. Difficult ones to be sure, but we have some very clever scientists and some very sophisticated tools that are improving at a non-linear pace. We may not crack the nut this week, but someone will eventually.
Selective breeding _is_ man made.
> Plants are also technology now. Why not a genetically modified plant that produces only the desired cannabanoids, or modified versions of the cannabanoids?
As I pointed out earlier in the thread, pure THC has worse therapeutic outcomes than the whole plant.
Purity != efficacy.
You could probably survive on protein powder and multivitamins, but no one would enjoy that.
Opiates are similar BTW. The whole poppy product provides relatively gentle rise and fall and an overall pleasant experience, whereas specific isolates can be quite harsh. It's called the entourage effect or synergistic interaction of the phytocomplex.
Right now, opiods are the closest thing we have to that, but they are like Cannabis in that they also have many less useful/safe side effects.
One day someone will find a drug that obliterates pain without damaging consciousness, and I suspect that society will become a more evolved place.
That has side effects too: https://en.wikipedia.org/wiki/Congenital_insensitivity_to_pa...
I suspect that whatever a "cure for pain" looks like it will involve modulating those signals to be lower, rather than eliminating them.