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Commentary: Confusion About Medical Marijuana And Chronic Pain- Pain News

Commentary: Confusion About Medical Marijuana And Chronic Pain- Pain News

There is great confusion about medical marijuana (MMJ) and how it works for specific kinds of pain in the minds of many who are seeking it, especially young adults in that all important demo of 18 to 35 year-olds.

MMJ can be helpful for certain kinds of pain — for example, the ache of fibromyalgia. The anti emetic and opioid sparing properties of MMJ make it an effective adjunct to chronic opioid therapy. And because MMJ helps many to sleep, it is beneficial in a common co-condition to chronic pain — insomnia.

MMJ contains two important classes of neuroactive proteins: tetra-hydro cannabinoids (THC) and cannabidiols (CBD).

It is safe to assume that every red-blooded American who tunes into the news has understands that THC is the psychoactive compound in MMJ, but many Americans, including people seeking an answer to their pain, are unaware of the role of CBD in pain management.

CBD, especially compounds that activate the CBD-2 neuroreceptor, are believed to play a role in pain control, and may have an effect on mu-opioid receptors, which initiate the major analgesic cascade that leads to opioid agonist-based pain relief. Pain writer Zyp Czyk has an interesting article that explores the role of CBD-2 on the glial cells that have been linked to pain sensitization and chronic pain’s public enemy number 1 — opioid tolerance.

But in a state of Washington study of MMJ last year reported in the Journal of Pain Research, MMJ samples from around the state contained very low quantities of CBD compounds in a chromatographic analysis, while THC content tested very high.

In Washington, here in Colorado, and in other MMJ states, medical consumers have little if any scientific information on the fraction of CBD in their ‘medicine.’ This is a huge problem for someone like me who needs more analgesia out of a limited dose of their opioid-based pain medication due to a high tolerance developed in over 20 years of treatment.

I wrote of how people are losing their medications because of misinterpretation of UDT for the National Pain Report last month.

The other big problem experienced by many people in pain who use MMJ to help fight their pain is that urine drug testing, which is part of the “universal precaution” protocol used in virtually every pain management office in America, tests for a wide spectrum of pharmaceutical and illegal drug metabolites, and pain doctors know when their patients use MMJ.

Many pain management offices have a zero-tolerance policy when it comes to illegal drugs, so the patient who is utilizing the beneficial effects of MMJ risks losing their access to opioid-based medications.

I’d suggest that people who are not clear on their pain practitioner’s policies regarding MMJ have a serious discussion with their doctor to prevent any misunderstanding and the loss of their opioid analgesics.


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