In 2016 it was estimated by the CDC that 20.4% of Americans have chronic pain. Chronic pain is a primary reason patients seek acute care, restrict physical activity, and potentially abuse highly addictive pain medications such as opioids. It is a component of many conditions but has developed into a health condition of its own category. As the legalization status of Cannabis continues to evolve, many questions have arisen regarding its potential applications as medicinal treatment for various conditions. One such condition is chronic pain. However, with this growing optimism, some concern is that the risks could potentially outweigh the benefits.
Marijuana has been historically labeled as a 'gateway drug' by many, and a recent study reviewed whether its use may have the potential to lead to opioid abuse, which is another highly lethal public health crisis we currently face. This study reviewed a comprehensive amount of evidence that was collected between 1977-2017. While it found that, yes, those who use Cannabis may be more likely to initiate opioid use, the evidence itself was deemed low quality with moderate risk of bias and inability to support a conclusive causal relationship. In fact, Cannabis use has been postulated as an additive treatment with opioids for chronic pain, given the two substances' synergistic effect. This year, a study in Frontiers in Pharmacology determined that better pain control was observed when THC, the active component in Cannabis, was introduced to select patients. These patients also required lower doses of opioids. Other recent large studies have yielded similar results in addition to demonstrating an associated improvement in quality of life.
As more data continues to emerge, we are not only learning about the potential of Cannabis to treat a variety of health conditions but also how its legalization will impact the overall public health landscape. While there are still many unknowns, we know that given the existing evidence, we cannot say with certainty whether the risks of Cannabis outweigh the benefits when it comes to the management of chronic pain. As such, arguments for and against its medicinal and recreational use remain a polarizing issue.
