#3: The Endocannabinoid System

CHRONIC PAIN & MEDICAL CANNABIS
By: Alice O’Leary-Randall
Executive Editor - Mary’s Cannabis Primer
Editor’s Note: This article first appeared
in Cannabis Now Magazine.
In the 2014 book, A Nation in
Pain, Judy Foreman offered a
stunning picture of America’s
growing problem with chronic
pain. Tucked quietly within that
volume is Chapter 10, “Marijuana:
The Weed America Loves to Hate.”
In it Foreman concludes: “to put it
bluntly, marijuana [for pain] works.
Not dazzlingly, but about as well as
opioids. That is, it can reduce chronic
pain by more than 30 percent. And
with fewer serious side effects.”
The same conclusion has been
reached by many Americans.
Marijuana Business Daily recently
reported that chronic pain comprised
a whopping 64.2% of patients in
those medical cannabis states that
track a registrant’s medical condition.
If you apply that percentage to the
estimated 100 million adults living in
chronic pain (Institute of Medicine,
“Relieving Pain in America,” 2011)
you can quickly see that nationwide
availability to medical cannabis
could have a profound impact on
the nation’s health, improve the
quality of life for millions, and,
6
not incidentally, vastly expand the
medical cannabis market.
Who Can Use and Where?
Of the 27 state laws that allow
medical access to cannabis, 22
specifically mention “chronic,”
“intractable,” or “severe” pain as a
qualifying condition. An additional
three— Illinois, New Hampshire,
and Massachusetts—give the
physician sufficient leeway to
recommend cannabis for pain. In
Connecticut, Florida and New Jersey
a patient with chronic pain must be
certified as terminally ill.
Another 17 states have the so-called
CBD-only laws but, in most cases,
use is restricted to pediatric
epilepsy patients.
The Research
Opponents of medical cannabis
are quick to single out the chronic
pain patient as some kind of pariah,
implying that pain is an “excuse”
to abuse drugs. They will say there
is no research to support the use
of cannabis in pain therapy when,
actually, quite the opposite is true.
A Google Scholar search using
the exact phrase “cannabis and
pain” reveals 27 studies between
2000-2016. Another 40 studies are