When it comes to chronic pain, Canadians are no strangers to it. Statistics report that 1 in 5 Canadians suffers from chronic pain, a condition associated with a significantly lower quality of life as compared to other chronic diseases. Selecting an appropriate treatment for chronic pain, however, remains a struggle. While opioids remain a popular choice, they pose several risks and deadly side effects such as overdosing, nausea and dependency, with risks increasing significantly with the size of the dose. Keeping this in mind, the potential for improved pain relief by combining cannabinoids with a lower-than-normal dose of opioids has been of particular interest to researchers
The Opioid Problem
Opioid prescription medications present several potentially deadly side effects, especially at higher doses. Overdose deaths from prescription painkillers have skyrocketed in the past decade, with nearly 15,000 people dying from overdoses involving these drugs every year - more than those who die from heroin and cocaine combined.
When it comes to long-term physical effects, opioid use can result in conditions such as hormone interference and chemical dependendency. It is important to note that a decade ago, Canada was sixth in the world for prescribing opiate drugs to patients. Today, it is a close second to the United States. Available opioids on the market come in a variety of names and colours, aiming to appease a large percentage of the population. For many Canadians, these prescription opioids bring relief from chronic pain, but to the approximately 200,000 Canadians hooked on painkillers, widely available access has led to what doctors are calling a national prescription drug crisis.
Cannabinoids and Pain
All this talk about chronic pain and opioids may have led you to question, where do cannabinoids come into the picture? Cannabinoids have been used for pain management for centuries, although the mechanisms have only been studied as of late. When used as analgesics in clinical trials, they have generally been well tolerated, with acceptable side effect profiles. Furthermore, strong laboratory evidence now underwrites anecdotal claims of cannabinoid analgesia in inflammatory and neuropathic pain. Sites of analgesic action have been identified in the brain, spinal cord and the periphery, which explains it’s wide range of therapeutic results.
Best of Both Worlds
Knowing the benefits of cannabinoids in treating chronic pain, researchers at the University of Texas Health Science Center studied this further and found that cannabinoid receptor agonists such as Δ9-tetrahydrocannabinol enhance the antinociceptive (pain sensitivity) effects of mu opioid receptor agonists, suggesting that combining cannabinoids with opioids would improve pain treatment.
Not surprisingly, Cannabinoids increase the antinociceptive potency of higher efficacy opioid receptor agonists more than lower efficacy agonists. Also, combining both therapies results in much smaller doses of each drug being administered while achieving adequate pain relief, which has a very high damage reduction potential if we remember that the risks associated with opioids increase significantly with the size of the dose.
Thus, taken together with previous work showing that cannabinoids fail to enhance other unwanted abuse-related effects of opioids, this data provides further support for combining the use of cannabinoids and opioids to effectively treat pain while, at the same time, reducing the risks associated with larger doses of opioids administered alone. Based on the current results in nonhuman primates, it will be of interest for future studies to explore the role of efficacy in opioid/cannabinoid combinations for treating pain in humans.
This post was contributed by OrganiGram Inc., a fully licensed, organic medical marijuana producer in Atlantic Canada. For more information, you can visit www.organigram.ca, email firstname.lastname@example.org or follow @OrganiGramInc on Twitter