Medical Marijuana vs Post Operative Pain

By Gooey Rabinski

Cannabis is proven to provide pain relief for a variety of conditions. Users tend to think of the analgesic (pain relieving) quality of marijuana in terms of specific diseases or ailments. It is widely understood that cannabis provides significant relief for Crohn’s disease, multiple sclerosis, and epilepsy. But what about more generalized conditions, like the pain and nerve damage that is frequently experienced following major surgery?

According to a study conducted in 2010, “An alarming portion of patients develop persistent or chronic pain following surgical procedures, but the mechanisms underlying the transition from acute to chronic pain states are not fully understood.”

A 2014 study in Australia of 1,514 patients using prescribed opioids revealed that 16 percent of them were supplementing with whole plant cannabis and 25 percent reported that they would have used marijuana to control their pain if it had been available to them.

While sativa varieties of cannabis tend to be the best for depression, pain relief is typically most effectively delivered by an indica strain. However, many sativa strains are also successful pain relievers.
One cancer patient who used cannabis to treat his pain following surgery reported:

“I would be using a 85 percent indica strain that I have used for the last few weeks to help with the original incision they made; it seems to be working a lot better then my heady sativas.”

The Studies

A study reported in 2006 conducted at Imperial College London involved 65 patients who had very recently undergone surgery. Each was given a cannabis extract called Cannador. Eleven patients received a 5 mg dose, 30 were given a 10 mg portion, and 24 received 15 mg. All of those who received the 5 mg dose requested additional pain killers, indicating that the dose was ineffective. Only 50 percent of those who received the 10 mg requested additional pain treatment, while only 25 percent of those on the highest dose (15 mg) required an additional analgesic.

One of the study’s researchers, professor Mervyn Maze, reported:

“We thought cannabis might be beneficial in helping manage pain following surgery, as previous research indicated cannabinoids help top up the body’s natural system for reducing pain sensation. This research proves it can be effective, with minimal side effects at low doses.”
Researchers noted that cannabis caused few side effects, making it especially safe for patients having just undergone surgery who often cannot tolerate conventional pharmaceutical drugs.
Dr Anita Holdcroft, a lead researcher from Imperial College London, stated:

“Pain after surgery continues to be a problem because many of the commonly used drugs are either ineffective or have too many side effects. These results show that cannabinoids are effective.”
A 2007 study at London’s University College Analgesia Centre involved a double-blind placebo-controlled trial. Participants were given a 12 mg dose of cannabinor, a cannabinoid-like molecule that binds to CB2 receptors in the body’s immune system. Researchers noted that administration of cannabinor produced a “statistically significant decrease in patients’ overall pain versus placebo.” Interestingly — and in contrast to the 2006 study — larger doses of the drug did not result in better pain relief.

Another 2007 study conducted by San Francisco General Hospital and the University of California’s Pain Clinical Research Center, as published in the journal Neurology, reported that inhaling cannabis significantly reduced HIV-associated neuropathy compared to placebo. Researchers reported that smoking cannabis three times daily reduced patients’ pain by 34 percent, concluding:

“Smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated neuropathy [in a manner] similar to oral drugs used for chronic neuropathic pain.”
Researchers at the University of California at San Diego in 2008 reported similar findings. As published in the journal Neuropsychopharmacology, researchers summarized:

“Smoked cannabis…significantly reduced neuropathic pain intensity…compared to placebo.”
A 2010 clinical trial at McGill University in Montreal was published in the the Canadian Medical Association Journal. The study involved 21 men and women with an average age of 45. One participant was a patient who had knee surgery, during which the surgeon likely cut a nerve, leading to chronic pain following the procedure.

Participants were rotated between cannabis treatments containing 2.5, 6, and 9.4 percent THC — or a placebo. All participants received all four treatments. “We’ve shown again that cannabis is analgesic. Clearly, it has medical value,” reported Mark Ware, assistant professor of anesthesia and family medicine at McGill University.


Needed for Chronic Pain

Chronic pain and nerve damage are common following surgery of all types. The efficacy of cannabis as an analgesic should be seriously considered by the medical establishment. The need for cannabis or cannabinoid extract therapy is only exacerbated by the negative side effects and frequent lack of response of patients to traditional pharmaceutical drugs. In addition, cannabis reduces the risk of addiction to opiates following surgery.

These studies, combined with anecdotal patient reports, reveal that cannabis is a viable option for the treatment of post-operative pain and surgically induced nerve damage and should be studied further.

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