Researchers Support Combining Marijuana and Opiods, Suggesting Improved Pain Treatment

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...

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.

Link to original study

This post was contributed by OrganiGram Inc., a fully licensed, organic medical marijuana producer in Atlantic Canada. For more information, you can visit, email or follow @OrganiGramInc on Twitter

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  1. greg_chainsaw Reply

    "It has long been recognized that opiates affect gastrointestinal motility. These effects, known as opioid bowel (or gastrointestinal) dysfunction are manifest as constipation, nausea, bloating, ileus and sometimes pain (1–3). When pain is the predominant symptom, the condition has been termed narcotic bowel syndrome (NBS). NBS is characterized by the progressive and somewhat paradoxical increase in abdominal pain despite continued or escalating dosages of narcotics prescribed in an effort to relieve the pain. This entity (4–6) was first reported two decades ago in the United States and 10 years ago in China (7). "

    For Patients like myself with Crohns and Colitis opiates should not be used in conjunction with marijuana but certainly marijuana should be used to wean those off of harmful opiates. The opioids not only don't help but worsen the condition in the long term and can lead to Narcotic Bowel Syndrome.

    "Opioid use is associated with decreased quality of life in patients with Crohn's disease";year=2014;volume=20;issue=3;spage=182;epage=187;aulast=Sanford

  2. CBD/MM Patient Reply

    Not only can opiates cause gastrointestinal pain, it can seriously compound mood disorders/depression. I know this from personal experience, but didn't put 2+2 together until I met somebody else who is also dealing with chronic pain, taking opiates and feeling suicidal. Exactly as I was.

    I finally decided to try medicinal marijuana for multiple medical conditions/injuries sustained through our appallingly bad medical care system, including weaning myself off a very high daily dose of opiates which were prescribed to me after doctors pushed another prescription medication on me which left me partially paralyzed. After fighting my way out of my wheelchair over 3 years - agonizingly painful itself - I was hurting to a degree I can't possibly explain. I literally felt like my life as I knew it was over. That being said, when I started using different forms of medicinal marijuana, I noticed positive results within the first week I began. Nothing has given me this degree of pain relief/ability to sleep normally in my life, whether I'm ingesting, vaping or applying topically. I've found that a mixture of all 3 - used at different times of the day but sometimes concurrently - give me the best relief with zero nasty side effects. In addition, I've noticed a massive change in my mood. Less than 1 year ago, I was incredibly suicidal due to the pain/sleep deprivation/depression I was going through on a daily basis. Just the thought of having to live in that condition for another year (although I wasn't living at all, just barely existing), never mind another decade, was enough to nearly push me over the edge. MM was my very last option. That or suicide, because alopathic doctors weren't able to do a damn thing about the damage they themselves created. It was a vicious cycle which I couldn't get out of, no matter what I did. The only thing suggested by doctors was antidepressants or a different opiate, both of which I immediately refused. Been there, done that, and I already know the sh*t-storm that would come from additional pharmaceuticals.

    Since I've started using various medical marijuana products, I haven't experienced a single day of depression. My pain is so well managed that I often forget about it, and when it does start flaring up a bit, I have the tools to immediately and effectively treat myself. 20 minutes, tops, and I'm ok again. Topicals work incredibly quickly for pain - providing I'm also keeping up my CBD intake in capsule or infused honey form every day - and edibles help me fall asleep and stay asleep. I hadn't had a good night's sleep in years (despite being prescribed valium & various other pharmaceuticals), which really contributes to chronic pain/depression/everything else, so this is groundbreaking for me. I can function. The simple act of taking a shower/getting dressed/going to the doctor/visiting friends & family/grocery shopping/walking our dog etc, all of which are things everybody takes for granted, no longer causes me anxiety as I know doing these things won't cause me to be in excruciating pain and to be laid up in bed for several days afterwards.

    I'm so incredibly grateful to all the people who are fighting these farcical, obscene, laughable, archaic, prohibitory 'laws'. THANK YOU! If not for you all, I'd be dead by my own hand or by the hand of some skeezy dealer who I'd be forced to buy from. I have a right to improve my quality of life, as does every human being, and I'm personally not about to give it up. Not after what I went through to get myself well. Legalize, period, no bogus 'legal' restrictions. Unfortunately for me, I'm in legal limbo. I discovered this medicine after patients were able to get their cards, so I take a chance every time I go shopping at my dispensary and drive my meds home. I'm just waiting for the day when I can grow my own and cut back on my monthly costs, which is the hindrance I'm currently facing.