Pain Management/Chronic Pain

Pain Management/Chronic Pain

Managing Chronic Pain With Medical Marijuana

Pain Management/Chronic Pain -Individuals needing assistance in the management of chronic pain have typically been suffering unwavering symptoms from weeks to years in duration. These can include severe bodily aches pain, sensory and psychological difficulty, and lead to a variety of issues from fatigue to an inability to participate in daily living activities. The scope of chronic pain sufferers is large, affecting more than 3 million individuals each year in the United States alone.

Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating.

With chronic pain, signals of pain remain active in the nervous system for months or even years. This can take both a physical and emotional toll on a person.

The most common sources of pain stem from headaches, joint pain, pain from injury, and backaches. Other kinds of chronic pain include tendinitis, sinus pain, carpal tunnel syndrome, and pain affecting specific parts of the body, such as the shoulders, pelvis, and neck. Generalized muscle or nerve pain can also develop into a chronic condition.

Chronic pain may originate with an initial trauma/injury or infection, or there may be an ongoing cause of pain. Some people suffer chronic pain in the absence of any past injury or evidence of body damage.

Traditional Treatment

There are numerous pharmaceuticals prescribed for the management of pain. These are often highly-addictive opioids with prevalent use and abuse recreationally. They include:

  • Valium
    Valium decreases activity in the nervous system, including the way brain signaling or communication takes place between various brain centers. When a user abuses the drug, they experience a high that includes:

    • Euphoria.
    • Lack of coordination.
    • Feeling of being drunk.

    After the Valium high peaks, there can be a period of withdrawal – experienced as a comedown or crash. The mellow feeling begins to disappear as the brain rebounds and speeds up from its drugged state and produces other undesirable effects, such as:

    • Anxiety.
    • Irritation.
    • Fever.
    • Rapid heart rate.
    • Stomach cramps.
    • Depression.

    Most addicts counteract the crash with more Valium or another drug to slow down the body and produce once again the sluggish, happy.

    The danger of continually taking Valium, however, is that the body quickly builds a tolerance that makes it harder and harder to reach the euphoric state with the same amount of Valium, so the user will need to take increasing doses – upping the risk of severe addiction and overdose.

  • Oxycontin
    OxyContin, the brand name for the drug oxycodone, is a potent synthetic opiate painkiller that is commonly prescribed for individuals who are struggling with moderate-to-severe pain. OxyContin is a lifeline for individuals who are struggling with chronic pain that occurs with some types of cancer, bone pain, heart attack, and severe burns. The time-release formulation provides hours upon hours of continuous pain relief for individuals in unremitting pain. Oxycodone, a Schedule II narcotic, is available only through a prescription from a physician for pain management. Unfortunately, a significant amount of Oxy is diverted and sold on the street.Similar to heroin, oxycodone produces – along with pain management – a euphoric high caused by stimulation of the reward center of the brain. Oxycodone elevates levels of the neurotransmitter dopamine, which is considered the pleasure chemical of the brain.Many users combine Oxycodon with other downers such as benzodiazepines or alcohol to further the high. This combination can be particularly deadly as all downers lead to respiratory depression, and the combination can cause death. Some individuals use Oxy with stimulants such as amphetamines, cocaine, and meth in order to subdue the unpleasant side effects of stimulant abuse. This combination can lead to consequences such as heart attack and stroke.
  • Percocet
    Percocet is a trade name for a prescription pain reliever that combines oxycodone and acetaminophen. Oxycodone is an opiate analgesic, a narcotic derived from the same source as heroin and morphine. The acetaminophen in the drug is the active ingredient in Tylenol. It is combined with oxycodone to increase its effectiveness. Percocet is prescribed for moderate to severe short-term pain that is not typically chronic in nature.Like heroin and morphine, Percocet affects the brain and the central nervous system, changing the way the brain perceives pain. When taken in large doses or when the prescription tablet is crushed to destroy the time-release mechanism, Percocet can cause the same high as heroin. Percocet is a central nervous system depressant that floods a person’s system with dopamine, so the high from the drug is characterized by euphoria and feelings of calm, relaxation and heightened pleasure.Percocet and other prescription drugs are often mistakenly viewed as a safer way of getting high than using illicit street drugs, like heroin and cocaine. Unfortunately, Percocet abuse can lead to the same dangerous problems of dependence and addiction as the illicit street drugs that share its origin.
  • Hydrocodone
    When taken as directed, hydrocodone can offer relief from pain, which leads to addiction in some users. As you continue taking the medication, your body changes the way it processes the drug. Your brain can eventually reach the point where it thinks that it must have the drug to get you through a normal day. This can even occur in patients who take the drug as prescribed by a doctor.Addiction relates to a term that doctors refer to as tolerance. Tolerance is the dosage that you take of hydrocodone before you feel the positive effects of the drug. When you continue taking the same size dose, your body adjusts to the amount. You might find that you need a higher dose before you feel those same initial effects of Hydrocodone use. If you keep taking more of the medication, you increase the chances of developing an addiction.

Physical exercise and rehabilitation techniques, as well as acupuncture and massage, are also utilized to treat chronic pain. Severe cases can involve surgery when necessary.

Treating Chronic Pain With Medical Marijuana

There has been significant research into the cannabinoid treatment of chronic pain, especially in individuals that have been resistant to narcotics. THC has been the most effective cannabinoid documented to date for pain management, resulting in a wide variety of strains that have been reported as effective.

Difference between CBD and THC in Medical Marijuana

THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana’s psychological effects. It acts much like the cannabinoid chemicals made naturally by the body, according to the National Institute on Drug Abuse (NIDA).

Cannabinoid receptors are concentrated in certain areas of the brain associated with thinking, memory, pleasure, coordination and time perception. THC attaches to these receptors and activates them and affects a person’s memory, pleasure, movements, thinking, concentration, coordination, and sensory and time perception, according to NIDA.

THC is one of many compounds found in the resin secreted by glands of the marijuana plant. More of these glands are found around the reproductive organs of the plant than on any other area of the plant. Other compounds unique to marijuana, called cannabinoids, are present in this resin. One cannabinoid, CBD is nonpsychoactive, according to the National Center for Biotechnology Information, and actually blocks the high associated with THC.

Cannabidiol or CBD, is the cannabis compound that has significant medical benefits, but does not make people feel “stoned” and can actually counteract the psychoactivity of THC.   CBD does not cause a high, unlike THC. The reason why CBD is non-psychoactive is due to its lack of affinity for CB1 receptors. CB1 receptors are found in high concentrations in the brain, and are the pathways responsible for the psychoactive effects of THC.

CBD and THC levels tend to vary between different strains and varieties of cannabis.  By using selective breeding techniques, we have managed to create varieties with high levels of CBD and THC.

These include the widely available strains of Blue Dream, OG Kush, Grand Daddy Purple, Jack Herer, Bubba Kush and Northern Lights. CBD strains have also been reported by patients as effective for managing pain.

How To Medicate

Cannabinoid treatment for pain management has been delivered via smoked and vaporized cannabis, as well as the oral administration of capsules, edibles, tinctures and mouth sprays. Studies display varying degrees of intervals and dosing, ranging from the smoking of cannabis every 3-5 hours, and the oral administration of THC/CBD extracts. The synthetic cannabinoids sativex and marinol are also known to be effective.

The benefit from smoking as a route of administration is instant action and the ability of the patient to self titrate the dose needed for relief.

Vaporizing or Vaping

If you don’t like the idea of smoke there is the option to vaporize. Vaporization does not use combustion to heat the medicine. Unfortunately there is some confusion out there about vaporizers. There are now hundreds of vaporizers to choose from. There are three basic types: pen, hand-help, and tabletop. The differences are in price, portability and size. Some vaporizers claim to be able to vaporize plant matter (flowers), wax and oils. Some can only do concentrates, some only oil. The most important difference is the method used to heat the medicine. There are basically two methods (with hybrids on the way)- conduction and convection.

True Vaporizing is done by convection, where air is heated, and in turn the hot air turns the medicine a to vapor which is then inhaled. Conduction Vaporizing happens when a hot element (metal plate, or bowl) touches the medicine. The medicine is placed directly in a metal or ceramic bowl or chamber that is heated which then heats the medicine and the smoke is inhaled. This is still combustion, and not truly vaporizing. This is closer to dabbing but with a much cooler heating element.

Smoking

The benefit from smoking as a route of administration is instant action and the ability of the patient to self titrate the dose needed for relief.

What’s Best for my Lungs?

The cleanest method to inhale medicine is true or convective vaporizing. It is better for your lungs since there is no burning or combustion.

Edibles

Edibles provide ways to eat or drink your medicine. Many medicated edibles and even bottled drinks are readily available at dispensaries. Be aware that most of the edibles at dispensaries are loaded with sugar and carbs. But basically what the edibles and drinks all contain are canna butter and/or canna oil. You can purchase these or easily make them at home to add to your own baked goods, snacks or even meals (especially if you are avoiding sugar or gluten).

Tinctures

Tinctures are not new. Until cannabis was banned in 1937, tinctures were the primary type of cannabis medicines. Tinctures are essentially alcohol extractions of whole cannabis (usually the flowers and trim leaves).

The best way to use tinctures is sublingually (under the tongue). Titration or dose control is easily achieved by the number of drops a patient places under the tongue where the medicine is rapidly absorbed into the arterial system and is quickly transported to the brain and body. All a patient need do with tincture is use a few drops, wait for the desired medical effects, and either use more or stop as the situation indicates. Tinctures can be flavored for better taste.

The Patient

Utilizing cannabinoid treatment to manage the pain associated with cancer, multiple sclerosis, HIV/AIDS and diabetes is well-documented in patients suffering from these diseases.

A FDA-approved trial that studied the effect of vaporized cannabis on neuropathic pain reported THC, even in doses as low as 1.29%, “provided statistically significant 30% reductions in pain intensity when compared to placebo. Furthermore, a 2013 clinical trial published in Neuropharmacology reported that THC in oral and inhaled form significantly decreased pain sensitivity and increased pain tolerance in healthy subjects exposed to experimental painful stimul

A 2013 article in the Journal of Pain, researchers noted that when vaporized cannabis was added to the daily regimen of morphine and oxycodone in chronic pain sufferers, cannabis appeared to “augment the analgesic effect of opioids.” Authors further concluded that the combination of the two “may allow for opioid treatment at lower doses with fewer side effects.”

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