Introduction

Did you know there are life-saving uses of Cannabis or Marijuana? It is true that it has many benefits and functions as a therapeutic agent. Cannabis is derived from a plant that has naturally occurring chemical constituents called cannabinoids, which can be extremely beneficial for us. They have many medical purposes, one of which includes managing chronic pain conditions.

A chronic condition is when the patient is in constant pain or illness for a long time. Examples of chronic conditions include Arthritis, Diabetes, Hypertension or Alzheimer’s disease. A disease is called chronic if it persists for a long time and there is no treatment for it - however, it can potentially be managed with medications and treatment. Studies have shown that chronic pain persists in 10% of the population which is roughly 60 million.¹ This has a heavy burden on healthcare and costly medications are not easily accessible to everyone therefore naturally occurring cannabis is a great alternative to alleviate the symptoms of pain.

Medical Cannabis

Medical cannabis comes from the cannabis plant and its main active ingredients are tetrahydrocannabinol (THC) and Cannabidiol (CBD) which has analgesic properties for relieving muscle pain. The active ingredient was discovered in the 1960s along with the discovery of cannabinoids which also have pain relieving properties. There are still some concerns regarding the use of cannabis since many people might exploit it for recreational activities which can lead to the problems of abuse. A THC concentration of 3.9%² has been shown to alleviate the pain symptoms. However, cannabis used in a supervised manner has shown many uses such as management of nausea, vomiting and seizures with less or no side effects.

Mechanism of Action of Cannabis in Pain Relief

The two main constituents of cannabis have the following mechanism of action: Tetrahydrocannabinol binds to the CB1 receptors which are located in the brain and central nervous system.³ Once attached, it helps to make the pain feel less intense.

On the other hand, CBD binds to CB2 receptors which are located in other parts of the body i.e peripheral nervous system.³ They help in pain relief due to their anti-inflammatory properties, therefore reducing the immune response towards an injury.

Benefits of Long-Term Medical Cannabis Use for Chronic Pain

Peripheral neuropathy

This is a condition where the nerves are damaged in the central nervous system which causes incorrect pain perception to the brain. The symptoms are pain in feet and weakness. A study was conducted where the patients suffering from peripheral neuropathy were given doses of cannabis for relief from the pain and results showed a significant decrease in the pain intensity. ⁴

Quality of Life Improvements

Cannabis can help to improve the quality of life of patients with chronic conditions as it reduces pain and inflammation and allows the patient to sleep peacefully without any problems. A good sleep also has positive effects on the outlook towards life, improving the individual's mental health.

Reduction in Opioid Dependence 

Opioids are also naturally occurring chemicals derived from plants whose natural ingredient is morphine. Morphine is also used to ease the pain symptoms. However, due to the addictive nature, there is a high incidence of addiction which may lead to severe side effects and withdrawal symptoms. Morphine can cause a lot of psychological problems and patients can suffer from withdrawal symptoms. So cannabis is a great alternative as it shows low pain scores as well, thereby decreasing the reliance on opioids.

Mood Enhancement and Anxiety Reduction

Chronic pain can develop into feelings of anxiety, depression and stress. Long term use of  Cannabis helps in reducing pain symptoms which helps in improving mood and helps in reduction of anxiety and stress.

Potential Risks and Adverse Effects of Long-Term Cannabis Use

While numerous potential benefits exist from using cannabis medicinally, there are also a number of potential risks.

Physical Health Risks

Respiratory

Cannabis, if frequently inhaled, can cause damage to the lungs by irritation of the respiratory tract. It can lead to problems such as Asthma, Chronic Bronchitis and Pneumonia, along with other complications such as persistent cough, wheezing and sputum. ⁵

Cardiovascular

Smoking of cannabis can cause heart problems such as heart attack and stroke. A study has shown that people who smoke cannabis frequently are likely to have a 25% increase in the risk ofheart attack and 42% increase in the risk of stroke.⁶

Immune system effects

Since the main mechanism of cannabis is by decreasing the immune response of the patient towards pain, it makes them vulnerable to be affected by the other infectious diseases. 

Pregnancy-related risks

Some studies show that pregnant women who are exposed to cannabis may potentially cause harm to the fetus and cause problems such as memory impairment and reduction in critical thinking. Breastfeeding women may expose the babies to cannabis constituents which can lead to complications to the baby’s brain development.⁸

Psychological and Cognitive Risk

Mental health issues

Cannabis can lead to many psychological problems such as anxiety, depression, stress, delusions, hallucinations and Schizophrenia. There are several studies that show that daily use of cannabis is associated with risks of schizophrenia.⁷ People who already have schizophrenia are at huge risk of worsening the condition.

Memory impairment 

Chronic Cannabis use also causes decrease in memory with leading to difficulty in memorizing and remembering information correctly. It can lead to brain fog with decreased attention and difficulty in learning. The memory worsens with the chronic use of cannabis.

Dependency

This is one of the most concerning problems related to cannabis use. Patients who are chronic users can develop a dependency to cannabis due to its addictive properties. Some patients have false psychological beliefs that their health depends on cannabis and that they can't be healthy without it. Some people have developed tolerance to medically approved doses of cannabis and increasing the dose can put the individual's life at risk, which may even result in death in severe cases. 

Summary

Cannabis is a natural herb derived from the plant cannabis sativa. Its main ingredients include THC and Cannabidiol which are both used in alleviating the pain symptoms by reducing the intensity of the pain and decreasing inflammation respectively. It has significant potential in improving a person's quality of life and health when monitored carefully under supervision by a doctor. Due to its potential for addiction, its use is still limited as along with addiction, chronic use can cause risks to cardiovascular, respiratory and mental health problems.