Cannabinoids Vs Opioids, Which Is More Effective At Treating Pain?

Opioids are a class of drugs that span from legal pharmaceuticals prescribed to combat chronic pain to illegal substances like heroin. Opioids work by binding to opioid receptors in parts of the body such as the brain and spinal cord. When opioids act on these receptor sites, they work to reduce the signalling of pain messages from the body to the brain. In doing so, sensations of pain are reduced and relieved. For this reason, opioids are commonly prescribed in cases of chronic and constant pain. Several types of opioids include codeine, fentanyl, hydrocodone, hydromorphone, methadone, and morphine.

Potential side effects of taking opioid medications include constipation, nausea, vomiting, and constipation. Patients can also begin to develop a tolerance to opioid medications, which means they require more and more of the substance to receive the desired effects. Although opioids do work to manage pain, this outcome can and does come at a cost. Opioids are associated with addiction and lethal overdoses, even when taken in recommended dosages.

During 2016, a massive 20,101 overdose deaths occurred in the US, that were related to prescription painkillers. The euphoria associated with high-potency pain killers can also lead to addiction. If patients manage to wean off of the drugs, they may experience withdrawal symptoms such as diarrhea, nausea, vomiting, muscle pain, anxiety, and irritability.

If a patient is in a serious amount of pain, then the risk of opioid painkillers may be absolutely worthwhile. However, the high frequency of deaths and cases of addiction related to these substances do give cause for concern. However, there does seem to be a viable and effective alternative that poses almost no risk and is associated with virtually zero deaths. This substance is cannabis.

CANNABIS IS A MUCH SAFER OPTION

Cannabis is an age-old, natural herbal medicine that has a wide array of medical uses and applications. The herb is reported to be effective at helping to treat and ease symptoms of chronic pain - the same painful sensations that opioids are prescribed to treat. In contrast to opioids, cannabis is well known to be an incredibly safe and nontoxic substance. A scientific study published within the journal Scientific Reports compares a long list of substances in terms of safety and toxicity. These substances include heroin, cannabis, nicotine, alcohol, methadone, amphetamine, and MDMA. Drugs that were classed as high risk included alcohol, nicotine, cocaine, and heroin. Cannabis was the only substance to pose a low risk of death.

A SAFE PAIN MEDICATION

The use of cannabis concerning pain management seems to be a very safe option. A scientific paper published within The Journal of Pain states that the use of medical cannabis for chronic pain over a period of one year appears to have a reasonable safety profile.

The authors of the paper also state that “Medical cannabis use over one year was associated with improvements in pain, function, quality of life and cognitive function.” Researchers note that daily cannabis use poses no greater risk to patients experiencing adverse events than non-users. They mention, “We found no evidence of harmful effects on cognitive function, or blood tests among cannabis consumers and we observed a significant improvement in their levels of pain, symptom distress, mood and quality of life compared to controls.”

It does appear that cannabis poses far less of a risk when it comes to side effects and toxicity. But does the herb offer the same level of pain relief to users as compared to opioids?

CANNABIS VS OPIOIDS

Cannabis appears to be an effective pain killer, so much so that it may have the potential to serve as a substitute for opioid treatments for pain. If this became a reality, it could have some life-saving outcomes, offering patients a far safer and perhaps more effective alternative. A paper published within the Journal of Psychoactive Drugs states that “there is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain.”

The authors of this paper mentioned that when cannabinoids are used together with opiates to treat pain, the pair induce more pronounced and effective relief. This in turn results in patients requiring less opiates and therefore being exposed to less of the undesirable side effects therein. Additionally, cannabinoids may be able to prevent patients from developing a tolerance to opiates. The authors state that “These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates.”

This research testifies that cannabis can help to partially substitute opioids and help to reduce the harm caused by this family of medication. But can the herb entirely replace opioids when it comes to soothing pain?

FURTHER RESEARCH

Some patients seem to prefer using cannabis in place of opioids, and proclaim that it even works better for them. A paper published within the journal Cannabis and Cannabinoid Research presents evidence for this.

Researchers used a survey to collect data from a group of 2897 medical cannabis patients during a study that aimed to examine the use of cannabis as a substitute for opioid pain medication. 34 percent of the sample group stated that they had used opioid pain medication within the past 6 months. A majority of the group reported that cannabis use provided them with pain relief that was just as effective as that induced by their other medications, but without the unwanted side effects. A massive 97 percent of the group claimed that they were able to decrease the amount of opioid medication they were taking because of cannabis use.

Furthermore, 81 percent of the group stated that cannabis use alone was more effective at treating their condition than taking cannabis alongside opioid medications. The authors of the paper state that “Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications. Medical cannabis patients report that cannabis is just as effective, if not more, than opioid-based medications for pain.”

CBD VS OPIOIDS

CBD or cannabidiol is uniquely positioned because of its non-psychoactive properties. The hemp-derived compound can be taken in moderately high doses with very few side effects. The WHO organisation has even gone so far as to release a comprehensive review that states “CBD exhibits no effects indicative of any abuse or dependence potential”. Just on that statement alone, you could already consider CBD as the preferential treatment for chronic pain, especially when compared directly to opioid-based medication.

When CBD is consumed, it triggers receptors in our endocannabinoid system. These receptors are found throughout the brain, vital organs, and parts of our nervous system. Provisional studies have shown that by agitating various receptors, CBD can be useful in treating the symptoms of chronic pain.
Provisional studies - 

There is, however, much work needed to establish the recommended dosage of CBD, its necessary concentration, and the most effective method of administration. Fortunately, research is growing by the day, so the hope is it will be a matter of when, rather than if CBD can help.