Sunday, June 11, 2017

Neuropathic Pain And Medical Cannabis

Chronic Pain, classified as pain that persists for longer than three to six months is a common debilitating condition that affects hundreds of millions of people each and every day. The severity of chronic pain varies but extreme cases can be completely incapacitating. Due to how long Chronic Pain can persist, both an emotional and physical toll is taken on the sufferer. Common causes and examples of chronic pain include but are not limited to: headaches; joint pain (arthritis); pain from injuries or accidents; back pain resulting from complications of the spine; tendinitis; carpal tunnel syndrome; pain caused by other ailments or infections; and even some medical therapies and treatments may result in long lasting, substantial pain. Oftentimes anger, anxiety, and depression accompany Chronic Pain.
Neuropathic pain is characterized as a pain state caused in the sufferer’s nervous system. Neuropathic pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers.  With this condition, an individual’s nerves may be damaged, dysfunctional, or separated completely. Causes and examples of Neuropathic Pain include but are not limited to: alcoholism, amputation and the resulting phantom limb syndrome, skeletal and muscular problems (pinched nerves), chemotherapy, diabetes, genetics, HIV/AIDS, Multiple Sclerosis, shingles, spinal injury, and even surgery. 
Using Medical Cannabis to Treat Neuropathic Pain
Cannabis is a complex medicinal plant that may actually be used to treat a variety of debilitating symptoms caused by a surprisingly large number of ailments. The reasons that cannabis benefits so many different illnesses and ailments boils down to the fact that some of the active pharmacological components of the cannabis plant mimic an internal chemical harm reduction system in the human body that keeps our health in balance – the Endocannabinoid System (ECS).

The ECS is controlled by chemicals that our body produces called endocannabinoids. Our endocannabinoids are responsible for keeping our most critical biological functions in balance such as sleep, appetite, the immune system, pain and more. When the body gets out of balance and moves into a state of stress, endocannabinoids go to work to fix the problem. The pharmaceutically active components in the cannabis plant mimic endocannabinoidsand so can be effective in helping the body manage crises and restore itself after trauma when the body’s endocannabinoids are not able to restore balance alone.
Its usefulness as a non-lethal medicine (you cannot die from an overdose of cannabis) cannot be overstated and its versatility in terms of how it can be consumed and as to how it can be useful for so many illnesses is something to be excited about. However, it is important to remember that consulting with your primary care physician should be your first priority when considering incorporating cannabis into one’s medical regiment and that cannabis is to be used as an adjunct therapy and not a replacement. It is also your responsibility to communicate with your doctor as to how your use of cannabis has affected your health and of your progress with utilizing medical cannabis.
Opioids are commonly prescribed for patients with chronic pain; however, opioid use can lead to (1) severe side effects, (2) addiction/dependence, and (3) death in cases of overdose (accidental or intentional). Although most patients with chronic nonmalignant pain who are prescribed opioids do not develop addiction/dependence, many develop abnormal/unhealthy drug-related behaviors (although the likelihood of developing these behaviors is decreased if patients are pre-screened for past addiction/dependence and alcohol/illegal drug use, and decision of whether or not to prescribe is modified given this information).
With that said, studies have shown that cannabis may be quite useful for treating individuals suffering from Neuropathic Pain for the following reasons: significantly reducing the pain itself; assisting with sleep should the pain cause insomnia; and with dealing with possible depression and or anxiety should the individual suffer from it.
Beneficial Cannabinoids and Terpenoids Useful for Treating Neuropathic Pain
The cannabis plant offers a plethora of therapeutic benefits and contains cannabinoids and terpenoid compounds that are useful for treating pain in general. In fact one study that analyzed both Tetrahydrocannabinol (THC) and Cannabidiol (CBD) published in a 2008 article in Therapeutics and Clinical Risk Management states that, “Cannabinoid analgesics have generally been well tolerated in clinical trials with acceptable adverse event profiles. Their adjunctive addition to the pharmacological armamentarium for treatment of pain shows great promise.”
CBD is the second most common cannabinoid in cannabis and the most common in hemp plants. CBD can generally represent 0.1-12 percent of the cannabinoid content of the the plant. CBD rich cannabis (4% or more) provides potent therapeutic benefits without the euphoria or lethargy of many high THC varieties. CBD and THC are believed to have a synergistic effect meaning that when they are both present at therapeutic levels, they are more effective together than they are alone. While THC is widely known for its psychoactive properties, CBD may be best known for its ability to counterbalance anxiety, tachycardia (rapid heartbeat), hunger and sedation caused by THC and its ability to control severe forms of epilepsy.

CBD was once considered a minor cannabinoid under the shadow of THC. What we know now is that CBD is as beneficial and versatile a cannabinoid as THC in addressing many hard to manage conditions such as diabetes, rheumatoid arthritis, cancer, epilepsy, antibiotic-resistant infections, alcoholism, PSTD and neurological disorders. CBD has very strong anxiolytic (reduces anxiousness), anti-convulsant, anti-emetic (reduces nausea), anti-inflammatory, antioxidant (stronger than vitamins C & E), anti-depressant and anti-psychotic properties. One of the most exciting aspects of CBD is its combined strong anti-inflammatory, anti-oxidant and neuro-protective properties which yields great promise for the treatment of Alzhiemer’s, Parkinson’s disease, and all neurodegenerative-related diseases. CBD also helps regulate blood pressure and is cytotoxic to breast cancer and certain other types of cancer cells while protecting healthy cells.
The following chart denotes which cannabinoids and terpenoids work synergistically with each other to create a therapeutic benefit. It may be beneficial to seek out strains that contain these cannabinoids and terpenoids.

Another great resource is from Americans For Safe Access Condition Based Booklet on Chronic Pain.