Is There Dose Dependency for Pain Reduction With Certain Medications?

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Chronic pain is the most common reasonpatients seek to use medicinal marijuana. This is not surprising considering
over 1/3 of Americans are dealing with some sort of chronic pain situations. It
is now understood that certain strains of marijuana act favorably towards
reducing a patient's pain. Is there a dose-effect? Meaning is medicinal marijuana effective to a certain amount/dose and then does it become counterproductive
above that?

Research out of UCSD shows that theremay actually be a dose-dependent effect, with higher doses actually INCREASING
the number of pain patients experienced. The study at UCSD consisted of
injections of capsaicin into healthy volunteers' forearms. Keep in mind that
capsaicin (also known as pepper cream) is a substance normally rubbed on the
skin to invoke a numbing response and pain relief. But in this case it was
injected under the skin, where it becomes painful by itself. After injecting the painful capsaicin,the volunteers smoked marijuana at 3 doses. The low dose had no effect, while
the medium dose decreased the pain substantially. However, the high dose
increased pain. What happened? The first issue is that no one reallyknows how marijuana works for chronic pain. Sure, it is understood that there
are receptors for the cannabinoids of marijuana in the brain and throughout the
body. But what happens exactly once the cannabinoids are attached to those
receptors is a mystery. It is well understood that smoking marijuana increases
heart rate by 7 to 12 beats per minute. But how does the brain receiving
cannabis tells the nerves not to send pain signals? Some research has shown that THC (themain active component of marijuana) has some pain reduction activity in cancer
patients. Cancer patients would fall into the chronic pain category in reality,
but technically most legal states have a separate category for cancer as a
reason for usage. There have been multiple studies showing that medical
cannabis is effective for chronic pain conditions such as cancer, but not
for acute painful situations such as for instance severe sunburn. Having stated that, there has been astudy looking at cannabis in conjunction with opioids for postoperative
medication requirements. The study showed a decrease in opioid requirements as
cannabis intake increased. However, that study did not go over a 15mg THC dose.
Would a higher dose have made the opioid needs increase as a counter-intuitive
effect? There is a lot we know about medical marijuana for chronic pain, and a lot of unanswered questions. The more studies that come
out, the better marijuana's use for chronic pain can be aligned with specific
dosing towards the condition for which it is utilized.  

Posted 26 May 2020

heenacruzl says
This is a great article, I read and enjoyed it
Posted 01 Jun 2020

sapna1990 says
Posted 07 Nov 2020

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