With medical marijuana increasingly available, more and more people are turning to drugs that contain cannabis to treat their pain. The thinking has been that these drugs help eliminate pain. The newest research, however, turns that theory on its head. Yes, cannabis helps with pain…but not by taking the pain away. Here’s what’s really going on…and which kind of cannabis works best.

To better understand the relationship between cannabinoid drugs (medications that contain cannabis) and pain, researchers from Syracuse University reviewed 18 placebo-controlled studies that looked at a total of 442 healthy men and women who did not have chronic pain. The researchers chose to look only at pain-free study participants because people who have chronic pain often also suffer from other conditions, including anxiety and depression, that can influence the effectiveness of cannabinoids. Instead, “experimental pain” was induced in the studies. Collectively, the studies looked at different aspects of pain—pain threshold (the level at which discomfort becomes painful)…pain intensity (how painful something feels)…pain tolerance…level of unpleasantness of experiencing pain…and increased sensitivity to pain.

Results showed that cannabinoids…

  • Slightly to moderately increased pain tolerance
  • Slightly to moderately reduced how unpleasant ongoing pain seemed to the study participants
  • Slightly increased the threshold at which pain started to be felt—and more effectively if taken before the pain started than for pain that was already being felt
  • Were more effective the higher the dose.

What the drugs didn’t do was take away the pain the participants felt. Cannabinoids did not reduce pain intensity or sensitivity to pain.

These results suggest that the way cannabinoids help with pain is by influencing the interpretation of pain—by decreasing the negative emotions associated with feeling pain—rather than by influencing the actual sensation of pain itself.

The study authors would like to see more research done to determine which types of cannabinoid drugs and what doses are most effective for dealing with pain. Meanwhile, their study did find that plant-based cannabis, rather than synthetic, was most effective at reducing pain’s unpleasantness…and plant-based cannabis and one synthetic cannabinoid (dronabinol, an anti-nausea drug) were each best at improving pain tolerance.

The affective level refers to my perceptual-emotional reaction to the pain. It was my perceived sense of what it was and my feelings about it.

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