By Max Sargent


The opioid crisis poses a significant threat to public health, particularly in the US, where its effects can already be seen. Consequently, many are now looking for alternative treatments for their pain—ones that do not cause addiction and fatal overdose.

Much like opium—one of humanity's oldest drugs—cannabis has been with us for millennia. Does it provide an answer to this crisis? Here we investigate whether cannabis has analgesic properties, where the research is currently, and ask, could cannabis provide an alternative to opioids?

What Are Opioids?

Opioids are a class of drugs that act on the body's opioid receptors in the central and peripheral nervous systems and the gastrointestinal tract. They have a long and varied history, being used by humanity for at least 7,000–8,000 years—bringing pleasure, pain relief, visionary experiences, addiction and death.

Derived from Papaver somniferum—the opium poppy—opioids come from opium, the narcotic latex found in the seed pods of the poppy plant. Over history, it has taken many forms, from smokeable opium to laudanum, heroin, morphine, fentanyl and oxycontin.

Opioids concurrently block out pain and cause feelings of euphoria. This makes them highly effective as a medicine for pain relief and gives them the massive potential for abuse. Tolerance develops quickly with opioids, as does addiction. This means that those prescribed opioids for pain relief can soon find themselves turning to them solely for relief from withdrawals.

Highly sought after for their addictive and euphoric properties, opioids have been used to suppress populations by colonial powers[1], fund terrorism[2], and fill the coffers of pharmaceutical companies[3]—all at the expense of the individuals using them.

What Are Opioids?

What Is The Opioid Crisis?

These days, opioids are wreaking their most significant damage in the US. The issue is so bad that it has been dubbed "the opioid crisis", which is no hyperbole. In 2017, the worst year of the opioid crisis so far, deaths due to overdose were estimated at a staggering 70,237. Of these deaths, 47,600 were attributed directly to opioids—that's 68%. To put this figure into perspective, in the same year the number of deaths attributed to conflict and terrorism in the US was put at 9[4].

Perhaps even more tellingly, 1.27 million Americans[5] are currently receiving medication-assisted treatment to deal with opioid addiction.

Disconcertingly, the opioid crisis stemmed from an over-zealous prescription of these drugs as a treatment for all things pain-related. Increasingly powerful drugs were developed, pushed, and handed out to people with little or no oversight. This then spiralled out of control and became an indistinguishable world of treatment, recreational drug-taking and addiction—each becoming the other.

Given how long opioids' destructive nature has been known, how were they so willingly given out in such high quantities?

How Did The Opioid Crisis Happen?

The US opioid crisis is characterised as having 3 distinct phases[6].

Phase 1—1991 to 2010

At this time, pharmaceutical companies began pushing for patients to be prescribed opioids for all manner of pain-related symptoms. To back up this push, a lot started presenting research that opiods posed little risk of addiction or overdose. There is debate over how much of this was down to poor research and how much was deliberate misinformation. Given opioids long and famous history of being addictive, we can only speculate.

Phase 2—2010–2013

Heroin, the cheapest and most readily available opioid, became increasingly popular. Deaths began to soar, with the death rate doubling between 2010 and 2012. Why? 86% of heroin users at the time claim they started out using prescription opioids and then moved onto heroin.

Phase 3—2013–present

Synthetic opioids, specifically fentanyl, became more available and pushed the death rate to unprecedented levels. In 2010, 14% of opioid overdoses were due to fentanyl; in 2017, it was 60%.

To lay the blame entirely at the feet of pharmaceutical companies is to oversimplify the matter, though. The Institute of Medicine identified the push of opioids to coincide with an increase in pain[7] and the perception of pain among US citizens. The reasons identified were the following:

  • Greater expectations for pain relief
  • Musculoskeletal disorders due to an ageing population
  • Obesity
  • Increased survivorship after injury and cancer
  • Increasing frequency and complexity of surgery

It is thought that these factors coalesced into the crisis we see today.

Could Cannabis Be Used Instead Of Opioids?

So what alternatives are there? Focusing on the negatives misses the point that pain treatment is a necessary part of modern medicine. To do away with powerful, pain-relieving medicine would mean committing many people to a massive degradation in terms of quality of life.

Cannabis and its constituent cannabinoids are the subjects of much investigation to determine whether they have pain-relieving properties and how effective these may be. Research is still reasonably young, and concrete conclusions cannot yet be drawn. Nevertheless, there is great cause for hope.

Research Investigating The Effect Of Cannabis On Pain

One thing we do know that immediately gives cannabis an advantage over opioids is that it is non-toxic, non-addictive (physically), and as such has a much better safety profile[8]. Compare the numbers in terms of fatal overdose in 2017:

47,600 from opioids 0 from cannabis



That's a big difference.

But does cannabis offer a legitimate alternative?

Research published in 2017[9] sought anecdotal evidence from those who used cannabis in relation to their pain—in total, they had 2,897 participants. What they found was that, among those users, feelings towards cannabis were overwhelmingly strong—with many users placing it on a par with opioids, but without the side effects or addiction—not to mention lack of withdrawal symptoms. Moreover, many of those who used cannabis claimed they were able to reduce their reliance on opioids.

A 2017 review[10] investigated the relationship between cannabis and pain and whether there was a difference between inhaled and ingested cannabis. The relationship between inhaled cannabis and non-cancer-related pain management appeared strong. On the flip side, ingested cannabis had a stronger relationship with cancer-related pain management but was weaker elsewhere. They concluded that their research revealed the need to develop a deeper understanding of how cannabis affects pain.

Another 2017 review concluded the same[11]. They recognised that existing clinical studies point towards cannabis having a solid relationship with pain mangement but that the exact mechanisms must yet be identified and understood. Furthermore, whilst overall cannabis appears to have a good safety profile, this too requires further investigation. Finally, they also noted that cannabis appears to have a role in reducing dependence on opioid-related pain relief.

What can we take away from this? Evidence, both anecdotal and clinical, suggests that cannabis has a quantifiable relationship with pain management. However, there remain some issues in a therapeutic sense. Such as, by what mechanisms does it impact pain? How best to administer cannabis, and at what dose? What about the potentially negative side effects of THC? Until these issues are answered, it is difficult to suggest how cannabis may be used in the most efficient way to bring the relief required by a patient.

Could Cannabis Be Used Instead Of Opioids?

CBD And Pain Relief

Most of the research has focused on cannabis as a whole. However, more and more research is isolating cannabidiol (CBD). The great interest in CBD arises from the fact that it has no psychoactive properties, few side effects, and has been determined by the World Health Organisation to pose no significant threat to health, nor exhibit any potential for abuse[12]

A review from 2020 investigated CBD's relation to pain[13] management and attempted to present a balanced approach for further study. They concluded that CBD does present effects in relation to pain, but that research is hampered due to the unregulated nature of the market and the absence of medical-grade CBD isolates. They suggest that whilst it holds promise, without a greater understanding of the mechanisms and a more regulated market, adulterated products and bad practices pose their own risks.

Fortunately, CBD has boomed in recent years and is legal in many parts of the world. Therefore it should become easier and easier for researchers to delve deeper as the market develops.

Can You Use Cannabis And Opioids Together?

What about the concomitant use of cannabis and opioids?

A 2020 study investigated nine studies covering 7,222 opioid and cannabis-using participants[14]. It found a 64–75% drop in opioid usage among those who also used cannabis. However, it claims that it could not draw causal inferences from these results. It will be necessary to use this as a stepping stone to more specific research using cannabis and opioids together.

Interestingly, not only is cannabis being investigated for pain management but there is a huge amount of research going into investigating the relationship between cannabis and addiction. Specifically, whether cannabis could help to overcome it. Opioids are one of the addictive substances being investigated, but results are still pending. Could it offer a bridge for those needing to ween off opioids while still managing pain?

Cannabis, Opioids And Pain: What Does The Future Hold?

Opioids continue to pose a significant public health threat, as well as offer relief from pain. What seems clear is that an alternative is, in many instances, necessary. While some chronic cases of pain may warrant highly addictive, opioid-based medications, many others do not. Far from offering relief, these substances cause long-lasting, hard to overcome, and sometimes fatal addiction in many cases.

But does cannabis have a role to play in the story of pain management?

It is currently unclear exactly what role cannabis will come to play in relation to pain and opioids. The mounting evidence makes clear that rigorous research is necessary to discover how cannabis may be able to help those in pain. Furthermore, greater investigation relating to individual cannabinoids such as CBD will help uncover some of the deeper mysteries of the plant, and hopefully of pain too.

Fortunately, cannabis-related legislation seems to be dropping away across the world, and this is making it easier and easier for researchers to investigate the potential effects of cannabis without having to apply for strict and impeding licences.

It seems, in time (and hopefully not too much time), we will offically come to know what cannabis can do for those who suffer from pain.

External Resources:
  1. Opium wars : the addiction of one empire and the corruption of another : Hanes, William Travis, 1954- : Free Download, Borrow, and Streaming : Internet Archive https://archive.org
  2. Afghanistan: what the conflict means for the global heroin trade https://theconversation.com
  3. Lawsuits Lay Bare Sackler Family’s Role in Opioid Crisis https://www.nytimes.com
  4. Deaths from conflict and terrorism - Our World in Data https://ourworldindata.org
  5. Opioid Crisis Statistics | HHS.gov https://www.hhs.gov
  6. Opioid Crisis: No Easy Fix to Its Social and Economic Determinants https://www.ncbi.nlm.nih.gov
  7. Relieving pain in america: a blueprint for transforming prevention, care, education, and research https://www.tandfonline.com
  8. DEFINE_ME https://www.jpain.org
  9. Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report https://www.liebertpub.com
  10. Cannabis and Cannabinoids for Chronic Pain - PubMed https://pubmed.ncbi.nlm.nih.gov
  11. Cannabis and Pain: A Clinical Review - PubMed https://pubmed.ncbi.nlm.nih.gov
  12. Cannabidiol (CBD) https://www.who.int
  13. A Balanced Approach for Cannabidiol Use in Chronic Pain https://www.ncbi.nlm.nih.gov
  14. Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: a systematic review - PubMed https://pubmed.ncbi.nlm.nih.gov
Disclaimer:
This content is for educational purposes only. The information provided is derived from research gathered from external sources.

Cookies settings

We are requesting your permission to use your data for the reasons stated below:

Functional cookies

Functional cookies help our website to function optimally and allow us to personalise certain features.

Preference cookies

Preference cookies allow us to remember information that influences the way our website looks, including your preferred language based on your region.

Analytical cookies

Analytical cookies give us insights into website traffic and customer behaviour, including how many people visit our site, how long they browse for, and which parts of our site they visit.

What are cookies?

Cookies are small pieces of data from a particular website that get stored on a user’s computer while they’re surfing the internet. Cookies have several different functions. Some of them track browser activity that enables businesses to deliver targeted advertisements. Other cookies serve to remember user login details to different websites to make jumping on social media, or other sites, a more fluid process. Because each cookie has its own unique ID, these pieces of data allow website owners to measure the unique traffic coming into their site.

Why do we use cookies?

Cookies come in handy when you visit our website. They ensure you stay logged in, that you can shop safely, and that the items you add to your cart stay there before you make a purchase. But cookies also help us. The data they provide allow us to improve our website and enable us to present you with targeted advertisements that are compatible with your interests.

What kind of cookies do we use?

Functional cookies

Functional cookies help our website to function optimally and allow us to personalise certain features.

Preference cookies

Preference cookies allow us to remember information that influences the way our website looks, including your preferred language based on your region.

Analytical cookies

Analytical cookies give us insights into website traffic and customer behaviour, including how many people visit our site, how long they browse for, and which parts of our site they visit.

How can I disable or delete cookies?

Not a fan of cookies? No worries. You can disable them (with the exception of necessary cookies) in your browser settings. However, blocking cookies may impact your browsing experience and prevent you from enjoying all of the technical features of our site.

Privacy Policy - Royal Queen Seeds

To ensure a safe online environment and guarantee adequate data protection, we strictly comply with all legal requirements. In this privacy statement, we provide information about how and for what purpose data is collected, safety measures, storage periods and contact details.


COMPANY NAME: SNORKEL SPAIN, SL (hereinafter ROYAL QUEEN SEEDS)

C/ Vilar d'Abdelà, 5 (nave 1) CP: 08170 de Montornès del Vallès

+34 937 379 846

support@royalqueenseeds.com


The present Privacy Policy sets out the terms on which we will treat personal data at ROYAL QUEEN SEEDS; this includes any personal data collected through our website https://www.royalqueenseeds.com/ as well as any other data we process in the course of our business activities.

ROYAL QUEEN SEEDS collects the following personal data for the purposes listed below:

SECTION 1 – PERSONAL INFORMATION WE COLLECT

1.1 Account purchases

Account purchases can only be made if you are in possession of a personal account. When you create an account or purchase something from our shop, as part of the buying and selling process we collect the following personal information that you provide to us:

This information is required for delivery. In addition, when you browse our shop, we automatically receive the Internet Protocol (IP) address of your computer. Based on this information, we can optimise your online experience and at the same time protect our online environment.

Purpose of data collection

We collect and store account-related data for the following purposes:

(a) to carry out obligations arising from any contracts between you and us, and to provide you with information, products and services that you may request from us;

(b) to set up, manage and communicate with you about your account and your orders;

(c) to conduct market research and analysis;

(d) to confirm your age and identity, and to detect and prevent fraud.

1.2 Newsletters

With your explicit permission, we may send you newsletters about our shop, new products and other updates. We send newsletters based on your explicit consent. In the event that you purchase a product, and in accordance with current regulations, we may send you commercial communications in accordance with the legitimate interest of our company, always about products or services similar to those you have purchased or contracted. In any case, you may exercise your right of opposition through the channels announced in this Privacy Policy. The following information is collected in relation to the newsletter:

We do not need to know the sex of the person in order to send the newsletter (data minimisation: by law we must ask for data that is strictly necessary to provide the service, and in this case knowing the sex is not necessary to send the newsletter).

Purpose of data collection

The data collected is used to:

(a) personalise our emails, including your name and gender;

(b) provide gender-specific content.

You can withdraw your consent at any time by using the link provided in the newsletter or the contact information provided in section 2.

1.3 Customer service and contact form

In order to provide appropriate support, our customer service employees have access to information related to the account. Consequently, their support will be highly effective and friendly. The data provided in our contact form is used by our CRM provider, SuperOffice. We will only use your details to respond to your message.

SECTION 2 – LEGITIMATE INTEREST

If you have purchased any of our products, please note that we may process your personal data for promotional purposes, based on Royal Queen Seeds' legitimate interest only to offer you products or services from our company and about products or services similar to those you have purchased. You may exercise your right to opt out of future messages by the means set out in this Privacy Policy or through any notification you receive.

2.1 How do you withdraw consent?

If you change your mind, you can withdraw your consent for us to contact you for the purpose of collecting, using, or disclosing your data at any time by reaching out to us at: support@royalqueenseeds.com.

SECTION 3 – DISCLOSURE

We may disclose your personal information if we are required to do so by law or if you breach our Terms of Service.

SECTION 4 – HOW LONG DO WE KEEP YOUR DATA?

At Royal Queen Seeds, we will not retain your data for longer than is necessary for the purposes described in this Policy. Different retention periods apply for different types of data; however, the longest period we will normally hold any personal data is 10 years.

4.1 Account information

Data relating to the account remains relevant for as long as the consumer is in possession of an account. Therefore, the data remains documented for as long as the account exists. When our customers delete an account, the associated data will be deleted within a reasonable period of time. Requests regarding the inspection or correction of stored personal data or the deletion of an account can be sent to support@royalqueenseeds.com.

4.2 Newsletters

In the event that you give us your consent to inform you about our products or services, we will keep your data until you express your wish not to receive any further communications from us. However, we regularly (every month) carry out a relevance check. Registered customers (and their personal information) will be deleted whenever customers do not reply to our request. In addition, our newsletter mailing has an opt-out feature. Consumers can withdraw their consent by using this opt-out feature.

SECTION 5 – COOKIES

Cookies are small information files that notify your computer of previous interactions with our website. These cookies are stored on your hard drive, not on our website. Essentially, when you use our website, your computer displays its cookies to us, informing our site that you have visited before. This allows our website to function more quickly and remember aspects related to your previous visits (such as your username), making your experience more convenient. At Royal Queen Seeds, we use two types of cookies: functional and analytical.

5.1 Functional Cookies

Functional cookies are used to enhance your online experience. Among other things, these cookies track what is added to your shopping cart. The use of these cookies does not require prior authorization.

5.2 Analytical Cookies

Analytical cookies are used for research and market analysis. The data collected with these analytical cookies is anonymous, making it unusable for third parties. The use of these cookies does not require prior authorization.

SECTION 5 – THIRD-PARTY SERVICES

Third-party services are required to conduct transactions and provide our services. In general, the third-party providers we use will only collect, use and disclose your information to the extent necessary to enable them to perform the services they provide to us.

However, certain third-party service providers, such as payment gateways and other payment transaction processors, have their own privacy policies regarding the information we must provide to them for your transactions.

We encourage you to read the privacy policies of these providers so that you can understand how these providers will handle your personal information.

In particular, certain suppliers may be located or have facilities located in a different jurisdiction than yours or ours. Therefore, if you choose to proceed with a transaction involving the services of a third party, your information may be subject to the laws of the jurisdiction in which that service provider or its facilities are located.

Once you leave our website or are redirected to a third-party website or application, you are no longer governed by this Privacy Policy or the Terms of Service of our website.

Web analytics service (anonymous data)

On this website we have integrated an element of a web analytics service (with anonymisation functionality). Web analytics can be defined as the gathering, processing and analysis of data about the behaviour of visitors to websites. An analytics service collects, among other things, data about which website a person came from (the so-called referrer), which sub-pages they visited or how often and for how long they visited a sub-page. Web analytics is mainly used for website optimisation and for a cost–benefit analysis of internet advertising.

Courier service

To complete deliveries we use a courier service. This courier service carries out the delivery between our company and the consumer's home. To complete these logistics, the company requires access to the consumer's name and address information.

Mailing service

Royal Queen Seeds uses a third-party mail service provider to send its newsletter. This provider has access to limited account information related to opt-in consent (e.g. email address).

Marketing services

Royal Queen Seeds has the support of a company that specialises in marketing and communication activities. Their access to personal information is very limited and mostly anonymous.

Payment services

At Royal Queen Seeds we use external payment services to handle our transactions (e.g. credit card payments).

SECTION 6 – SECURITY

To protect your personal information, we take reasonable precautions and follow industry standard best practices to ensure that it is not inappropriately lost, misused, accessed, disclosed, altered or destroyed.

If you provide us with your credit card information, the information is encrypted using secure socket layer technology (SSL) and stored using AES-256 encryption. Although no method of transmission over the internet or electronic storage is 100% secure, we follow all PCI-DSS requirements and implement additional industry standards that are commonly accepted. Information related to the account is protected with a hashing method. This method transforms the information into a generated hash. As a result, confidential information is protected and invisible, even to us. In addition, our databases are exceptionally protected against unauthorised access. For example, access to the database is only possible and permitted via approved IP addresses (e.g. from Royal Queen Seeds headquarters). Other attempts and addresses are rejected at all times.

Furthermore, data is anonymised as much as possible, so it cannot be directly linked to a specific consumer. With this data, however, we may be able to carry out market research and analysis. In addition, the third parties concerned (e.g. mailing service) are examined prior to our collaboration, comply with the GDPR from the EU and receive a processing agreement. Within Royal Queen Seeds, employees are assigned different access permissions. Specific permission provides access only to information that is strictly required to perform a task. Digital security measures are subject to change and must meet high requirements to ensure the safety of online customers. That is why, at Royal Queen Seeds, we appoint a security officer. Regular verification and improvement of security measures (where necessary) are part of the role.

SECTION 7 – CHANGES TO THIS PRIVACY POLICY

We reserve the right to modify this Privacy Policy at any time, so please check back regularly. Changes and clarifications will be effective immediately upon being published on the Website. If we make substantial changes to this policy, we will notify you here that it has been updated so you will know what information we collect, how we use it and under what circumstances, if any, we use and/or disclose it.

SECTION 8 – YOU HAVE THE RIGHT TO: