"I know marijuana can help with my pain, but whenever I have smoked it, I don’t feel good. What other ways can I help manage my chronic pain?"
It has been shown that cannabis can help relieve pain. Since most strains of cannabis can contain various concentrations of THC and CBD, people can react differently to each of the various strains. Everyone has a different level of tolerance to each of components of cannabis and smoking is only one way to help treat your pain.
Using tinctures and capsules are another way to find the right combination to help alleviate painful symptoms. Each of them can be found with varying levels of THC and CBD. While CBD has the anti-inflammatory component, some products add a small amount of THC for the best relief of symptoms. You can use edibles as well that, while taking 1-2 hours to take effect, can last longer then other methods. While you can feel the effects of smoking or vaping within minutes, these other methods may be better since they will have a more gradual onset and can be more pleasant to help with your pain relief.
Perry Solomon, MD
I never really recommend smoking if you are looking to control pain. Inhalation is a fine method for pain relief as the analgesic effects are very quick to take effect, but I always recommend vaporizing if you plan to inhale cannabis.
Very generally, cannabis is made up of CBD and THC. THC is the part of the plant that is psychoactive and can result in the ‘high’, the euphoria or even paranoia depending on how you, personally react to it. CBD is the part of the plant that has been identified as being useful in the treatment of pain and inflammation.
If you smoke bud or flower, you have no way to separate out the THC from the CBD and will be subjected to the psychoactive effects of the THC contained in the strain you use. If you don’t like these psychoactive effects, you could use a product that has been manipulated to contain larger quantities of CBD than THC. These ‘CBD heavy’ products often still include a small quantity of THC. In studies, it has been shown that CBD products with a small amount of THC are more effective at reducing pain that products that contain CBD alone.
Here are some examples of CBD heavy products:
Topical applications such as creams, salves, balms and lotions, which I find particularly helpful for pain control during the day when you need to be functional and not high. When applied to the skin there is not enough absorption of THC into the blood stream to result in any psychoactive effects.
Tinctures can also supply larger amounts of CBD in relation to THC. Some examples are 20:1 or 30:1, CBD:THC. These are placed on or under the tongue usually and are absorbed through the oral mucosa. They useful for medium term pain relief with the effects starting anywhere from 15-45 minutes usually, they can provide pain relief for 4-5 hours in some cases. Tinctures are also, often nicely labelled with the amounts of CBD in milligrams, making dosing and evaluation of effectiveness easier.
Ingested cannabis or ‘edibles’ can also be made into CBD heavy products. These can provide longer term pain relief, sometime for 8-10 hours making them particularly useful for twice daily dosing. Again, they are often nicely labelled with the amounts of CBD in milligrams, making dosing and evaluation of effectiveness easier.
I like the tinctures, you can start at a low dose and work your way up until you feel comfortable.the 4:1 ratio is good,