The inability to manage pain can be one of the most debilitating and life-altering experiences a person can have. If you’ve ever experienced serious pain, you know how good it feels to get relief from that pain. That’s why it’s easy to understand and empathize with a person who becomes dependent on the source of that relief. Opioids are powerful pain killers. There is a reason people like to take them: they work!
With a large variety of low-cost, easy-to-prescribe opioid pain killers widely available, it’s also understandable how this problem became so widespread. We know it’s a major problem because it’s one of those rare instances that both the news media and the White House agree: this is a crisis — the “opioid crisis” is taking 60,000 American lives every year.
I’m a board-certified anesthesiologist and run a group of eight pain management clinics where together with other physicians, nurse practitioners and caregivers, we have helped thousands of patients with significant chronic and acute pain issues. In rural North Carolina, the hemp-based CBD-only state where I practice medicine, we are at the epicenter of the opioid crisis.
Our practice started recommending hemp-based CBD to select patients in our pain clinics a couple of years ago, tracking their progress along the way. We have made some remarkable discoveries about CBD, some of which I’ll share in this column. Please know that everything I share with you will be first-hand, clinical observations.
Is cannabis better than opioids? Yes. And here’s why:
CBD won’t kill you.
CBD is not an opioid and does not work like an opioid. Opioids are powerful painkillers that work by attaching to opioid receptors in the brain. One of these receptors, the mu receptor, causes respiratory depression when activated in the brainstem. While opioids are very effective in addressing pain, they are really nothing more than a band-aid. Opioids don’t address the root of the problem; they just cover it up. Cannabis/CBD not only helps with pain and inflammation directly, but it also helps the body to heal itself. CBD works by modulating the CB1 (in the brain) and CB2 (in the immune system) receptors that influence many aspects that cause pain, as well as the perception of pain.
When first diagnosed with chronic pain, a patient should first use the safest products with the best safety profiles. That is why I always recommend patients start with a non-opioid therapy before ever considering an opioid medication. CBD fits perfectly in this non-opioid category. CBD’s safety profile is important from a risk reduction standpoint. The fewer prescription medications and the shorter time we take these medications the better. Going straight to a narcotic when addressing acute or chronic pain places the individual at too high a risk of developing an addiction – or worse yet a complication that leads to increased morbidity or mortality.
Cannabis does not cause respiratory depression, even at high doses.
On the other hand, as mentioned above, opioids are well known to cause respiratory depression on their own, and especially when combined with benzodiazepines (Xanax and Valium), alcohol or other medications. It’s too easy to be on an opioid and decide to have a beer or two while watching the game with friends, go to bed and never wake up. Yes, that can happen with opioid use; it can never happen with CBD use.
CBD has strong anti-inflammatory properties.
It doesn’t help that our bodies are in a hyper-inflammatory state most of the time given the pro-inflammatory diets we consume. We eat too much from the inside aisles of the grocery store and not enough from the outside aisles. Whether we’re talking about arthritis, fibromyalgia, inflammatory bowel disease, back and neck pain, migraines or other pain-inducing issues, inflammation is usually a component of pain. Inflammation is everywhere and it’s the first thing we should be addressing. So, on the first sign of pain, start eating a low-inflammatory diet and use anti-inflammatory products like CBD creams and oils to reduce the inflammatory component of your pain. Hemp-based CBD products that can be purchased online or over the counter across the country work just fine for this purpose.
CBD has shown to promote new bone growth.
CBD works very well for pain that is associated with bone healing. We had a patient recently who was suffering from a non-healing bone fracture that quickly healed after taking CBD. Opioids don’t promote bone growth.
Opioids stunt brain growth.
They decrease neurogenesis, or your ability to learn. Cannabis, on the other hand, causes neurogenesis (the development of neurons in our nervous system) or neuroplasticity (your brain’s ability to be resilient and recover from injury). Neurogenesis and neuroplasticity are critical as our brain and nervous system deal with new pain. It is way too easy for our brains to get stuck in the chronic pain rut, and for us to become hopeless. Helping your brain problem solve its way out of pain is extremely important. You may laugh, but I’m serious. We’ll save that for another article, but hope and brain remodeling are also proving to be powerful tools in this fight against the opioid crisis.
CBD does not have a lethal dose and it has a large therapeutic window.
Opioids, on the other hand, have the worst possible combination of an unpredictable lethal dose with a very narrow therapeutic effect window. Virtually every pharmaceutical drug has a lethal dose. You can even overdose on aspirin and Tylenol. However, there have been no reported deaths attributed to cannabis. The large therapeutic window allows patients using cannabis to be comfortable taking as little or as much cannabis as needed to positively affect their pain without the worry of overdose.
There are great studies that confirm our clinical experience and demonstrate how cannabis helps with pain, but finding the right dose and cannabinoid profile is sometimes elusive. That’s why working with physicians or other medical establishments familiar with the Endocannabinoid system is crucial for success.
Whether you are currently taking a narcotic for pain or experiencing pain for the first time, you should consider cannabis, including hemp-based CBD, as one of your first-line therapies. Not only will it address your pain, but the additional benefits of improved sleep, reduced inflammation, reduced anxiety and a feeling of hope await you as well.