The debate over whether medical cannabis is an effective treatment for pain continues unabated. Fuel was added to the fire in late 2022 when a meta-analysis published by JAMA Network Open suggested cannabis performed no better than placebo. But from my observation as a freelance writer and disinterested third party, much of the debate misses the point entirely: different types of pain demand different treatment options.
Anecdotal vs. Clinical Evidence
Countless numbers of medical cannabis patients swear by their drug of choice. They say it does wonders to relieve their pain, even if some clinical studies suggest the opposite. On the other hand, there are medical professionals who insist that it is all in the mind. They claim that cannabis does nothing to relieve pain.
For their meta-analysis, researchers looked at 20 previous clinical studies involving more than 1,400 patients suffering from neuropathic pain or multiple sclerosis. Both types of patients are legitimate in terms of their pain complaints. But neuropathic and multiple sclerosis pain are by no means inclusive representatives of the entire pain spectrum. Those who see the meta-analysis as evidence against medical cannabis seem to not grasp this.
Pain Is a Symptom of Something Else
Rare is the patient for whom pain is the only condition being treated. Most of the time, pain is a symptom of something else. The pain experienced when touching a hot stove is a symptom of the effect of high heat on skin cells. It is also a warning to take your hand off the stove.
Likewise, the pain experienced with a broken bone is the result of both tissue damage and nerve irritation. You would not treat it the same way you would treat pain resulting from a burn after touching the stove.
Burns can be treated with topical ointments. If necessary, and over the counter (OTC) pain reliever offers an adequate level of analgesia. The pain of a broken bone cannot be treated topically. Patients usually start with oral prescription medications before gradually moving to OTC products.
Pain Is a Very Personal Thing
It is true that we struggle to understand how cannabis might relieve pain. Our struggle is directly related to two factors:
- Lack of Research – Cannabis hasn’t gotten nearly enough attention from researchers over the years. It certainly has not been studied as extensively as narcotic pain relievers.
- Pain Perception – Pain perception can vary greatly from one patient to the next. In addition, there is no concrete way to measure pain. Pain is relative in every sense.
Another way to look at pain is to understand that it’s a very personal thing. One patient who visits Utahmarijuana.org hoping to find information about treating chronic pain with medical cannabis may have a very low threshold for pain. Another patient may never visit the website due to a much higher pain threshold.
It is interesting to note the Gate Control Theory of Pain in this regard. First proposed in 1965, the theory suggests that nerves act as gates for pain signals. Open some gates while closing others and it’s possible to reduce the sensation of pain.
As Many Options As Possible
Whether the Gate Control theory is legitimate or not, there is no denying that people experience pain differently. There is also no denying that there are different types of pain caused by any number of conditions. To assume a one-size-fits-all approach to treating pain is foolish.
Patients need options. They need as many options as we can give them. Medical cannabis should be one of those options as long as it’s treated like any other prescription medication.