Critical cannabis research has increased due to state-level legalization and heightened cultural interest in the plant’s medicinal value. Fortunately, these efforts have begun to bear fruit. Particularly, recent findings point to cannabis’ mid-level analgesic (pain-relief) properties.
An uncontrolled trial initially found that “…patients with chronic pain showed improvement from baseline in pain and pain-related QoL [quality-of-life] outcomes following treatment with medicinal cannabis.”  The study also showed a 44% decrease in patients’ opioid consumption, further pointing to cannabis as an equally effective and less harmful alternative to opioids.
A more recent study on cannabis as a mid-level analgesic supports these findings. This research utilized data from the Releaf App™, a smartphone application that measures patient experience “across five pain categories: musculoskeletal, gastrointestinal, nerve, headache-related, or non-specified pain.”  Out of 2,987 patients who completed 20,513 cannabis treatment sessions, the study used data from 53.5% (n=1,598) of users and 34.3% (n=7,036) of sessions. In addition, the study tracked pain relief across individual cannabis product types, (i.e., concentrates, tinctures, topicals, pills, flower, and edibles, and further separates them by phenotype classifications C. sativa, C. indica, or hybrid. The genetic reliability of these phenotype classifications has been called into question.  Nonetheless, they still inform consumer perceptions and warranted inclusion in the study to elucidate certain findings.
The findings of the study are certainly promising. On average, the sample showed a pain reduction of approximately three points on a pre-determined 0 to 10 visual analogue pain scale, further supporting cannabis’ capabilities as a mid-level analgesic.  In addition, cannabis flower products had a greater association with pain-relief via patient input compared to other products, including edibles, concentrates, and tinctures. Interestingly, concentrate users reported more negative effects in comparison to flower users. The study hypothesizes that this negative response can possibly be attributed to solvents and removal of many terpenoids and other beneficial phytochemicals. That said, more research needs to be done.
Outside of cannabis product types, the biggest predictor of pain relief was tetrahydrocannabinol (THC) levels. Higher percentages of THC (i.e., 10-35%+) were generally associated with greater pain relief across musculoskeletal, headache-related, and the “other/non-specified” pain categories, while lower THC percentages showed greater effectiveness in treating gastrointestinal pain.  Cannabidiol (CBD) showed the most unlikely results. It was found that high percentages of CBD (i.e., 10-35%+) did not correlate with pain relief although they mitigated some side effects, especially negative ones, but also some of the positive effects on abdominal pain and other/non-specified pain. This only further muddies the waters in determining the efficacy of CBD treatments which is essential in a booming industry that needs reputable research to counter dubious branding and claims.
The findings of this study should not be undervalued. As research and data suggests, cannabis has great potential as a mid-level analgesic for an array of conditions including headaches, nerve pain, etc. For the budding cannabis industry, astute medical findings like this bolster cannabis’ newfound position in medicine as an alternative to established therapeutic practices. It will be exciting to watch the story of cannabis in the 21st century unfold.
- Haroutounian S, et al. “The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain.” The Clinical Journal of Pain, vol.21, no.12, 2016, pp.1040-1043. Impact Factor: 2.893; Times Cited: 94
- Li X, et al. “The Effectiveness of Self-Directed Medical Cannabis Treatment for Pain.” Complementary Therapies in Medicine, vol.46, 2019, pp.123-130. Impact Factor: 1.979; Times Cited: 2
- Schwabe AL, McGlaughlin ME. “Genetic Tools Weed out Misconceptions of Strain Reliability in Cannabis sativa: Implications for a Budding Industry.” J Cannabis Res, vol.1, no.3, 2019, pp.9-10. Impact Factor: N/A; Times Cited: 3