by Dr. Joseph Cohen
Many of us can either limit the use of, or completely avoid, opioid prescription drugs for treating acute, chronic or neuropathic pain.
When used appropriately cannabis not only reduces the need for potentially harmful or addicting medications but can actually enhance our health. A clear example of this benefit is seen with the non-psychoactive phytocannabinoid known as cannabidiol (CBD), which I consider to be the most medicinal part of the cannabis plant. CBD, when derived from hemp, will have less than 0.3% THC and can be purchased throughout the country without a medical marijuana recommendation from a physician.
THC, the psychoactive phytocannabinoid, can be consumed in a variety of ways and can have immediate pain-relieving effects. Inhalation provides the most immediate effects on pain, but generally lasts about 2 hours. Tinctures generally take about 20-minutes to work and last about 4 hours and ingestible forms can take effect after an hour and last up to 6-8 hours. Certain strains of cannabis can give the user different effects. This is not only due to the cannabinoids in that particular strain, but is mostly due to the terpene profile of that strain. Terpenes, found in a variety of plants, will actually alter the effect of a particular strain. Examples of this are found in Sativa (daytime, awake, alert, creative) and Indica (night-time, body relaxing and pain-relieving) strains of cannabis.
CBD, obtained from marijuana or hemp, works in a different way and can actually enhance the pain-relieving properties of THC. The most effective ratio of CBD to THC appears to be 1:1. CBD not only enhances the pain-relieving effects of THC, it also decreases some of the potential negative side effects of THC (psycho-activity, anxiety and tachycardia). When treating acute pain, it is best to combine CBD and THC.
CBD can be utilized from full-spectrum hemp. This allows its use throughout the country and
can be used while driving or at work. This is a huge advantage that hemp-based CBD has over marijuana-based CBD. Full spectrum means that the plant has all of its parts and has not had other cannabinoids and terpenes removed during processing. In addition to having pain relieving qualities, CBD is a great anti-inflammatory component of the plant. In most patients, full spectrum hemp CBD does not work as soon as you use it for pain.
It is a gradual process that may take a few weeks to kick in while it gradually reduces the
inflammation that can be associated with pain. Many of our patients use hemp-based full
spectrum CBD to excellent results. CBD has other benefits. CBD actually helps our body and
mind run more smoothly by allowing our own cannabinoids (anandamide and 2-AG) to perform their function of maintaining balance and homeostasis.
When treating pain, I recommend twice daily 25mg of CBD in either sublingual or capsule form. It should be used as a daily supplement especially since it provides so many other benefits to our health. Adding THC from marijuana can enhance pain relief when appropriate.
In summary, full-spectrum hemp-based CBD used twice daily along with marijuana-based THC as needed gives optimal results for relieving pain.