Following the passing of Proposition 215 in 1996—also known as the Compassionate Use Act—California became the first US state to legalize cannabis use. The ruling meant that cannabis could be prescribed for a number of ailments, including migraines and chronic pain.(1)
In the decades since, several other states have followed suit, prescribing cannabis and its constituents for pain and a host of other issues. However, we have yet to reach a universal consensus on whether cannabis can actually alleviate pain.
So, what does the science say? Can cannabinoids like THC, CBD, CBN, and CBG really help with pain?
The Effects of Cannabis on Pain
In 2023, a Finnish study sought to discover how cannabis compared to commonly prescribed opioids in the treatment of chronic pain. It took reports from over 200 patients, 161 of which were opioid users, while 40 used cannabis.
The study noted that cannabis users reported more positive “emotional” and “holistic” effects than opioid users and concluded that opioids and cannabis were “as equally efficacious in reducing pain intensity”. It added that the cannabis group had a greater sense of well-being and more functionality, with the suggestion being that these improvements could indirectly reduce pain and thus provide more benefits.(2)
An Australian study drew slightly different conclusions, noting that there was “ no evidence that cannabis use reduced pain severity”. However, the study largely focused on recreational users.(3)
The strain of cannabis used may play a role in these differences. A 2014 web study surveyed 95 cannabis users and found that a much higher proportion of participants preferred Cannabis indica strains when treating pain (as well as insomnia), with many using it for non-migraine headaches and joint pain in particular.(4)
These results could be due to the chemical makeup of each strain. Sativa strains, which are often used to produce a “mind high” and are said to be energizing, have higher levels of tetrahydrocannabinol (THC) and lower levels of cannabidiol (CBD) than indica strains, which provide a more mellow and sedate experience.
When we think of the pain-killing properties of cannabis, the mind instantly jumps to THC. It’s the main constituent compound, and it’s also the one responsible for its psychoactive effects. But it seems that CBD could play an even bigger role, and it’s able to do this without producing the typical “high” that people associate with marijuana.
The Effects of CBD on Pain
In 2019, researchers from the Netherlands compared the analgesic effects of two cannabis formulas against a placebo. The best results came from a formula known as Bediol, which contained 13.4mg THC and 17.8mg CBD. Participants given this substance reported a 30% decrease in pain scores compared to placebo. It also beat Bedrocan, which has 22.4mg THC and less than 1g CBD.(5)
CBD has also shown positive results when taken in isolation, with research suggesting it can help with neuropathic pain, joint pain, and chronic pain.(6)(7)
What’s more, patients tolerate high doses of CBD better than they do THC, and many users experience few to no side effects.
In 2017, for instance, high doses of CBD were given to patients who had recently undergone kidney transplants, a condition for which “chronic pain is a major therapeutic problem”. Two of the seven patients had “total pain improvement”, four had a partial response, and only one reported no change. A follow-up found that the CBD had been well tolerated, and there were no serious or lingering side effects.(8)
The Effects of CBN on Pain
Cannabinol (CBN) has not been as widely studied as CBD, but as it becomes more popular, we’re seeing more trials, more research, and a lot more intriguing results.
A 2024 report on CBN found that it possesses anti-inflammatory properties. It’s also commonly used as a sleep aid, something which may help chronic pain sufferers whose pain keeps them awake at night. The study noted that the cannabinoid’s analgesic effects “may have a role in pain management, particularly for neuropathic and inflammatory pain.”(9)
The Effects of CBG on Pain
Cannabigerol (CBG) could be a more effective analgesic than THC and even aspirin, according to a study from 1988. As with CBN, it hasn’t been as extensively studied as CBD, but what we do know makes for interesting reading.(10)
This often overlooked cannabinoid displays strong anti-inflammatory effects, particularly with regard to gastrointestinal and joint inflammation. Many existing studies were conducted on animals, but there is an abundance of anecdotal reports from users who swear by compounds like CBG and use them to treat a host of pain-related ailments, either on its own or in combination with other compounds.
How to Use Cannabinoids to Manage Pain
Whether you’re using cannabinoids to help you sleep, stimulate your appetite, or manage pain, they work best when taken in combination. It’s known as the “Entourage Effect”—the idea that the whole is greater than the sum of its parts. In other words, multiple cannabinoids work together to stimulate the endocannabinoid system (the body’s internal cannabinoid system) and provide benefits such as reducing inflammation, stress, and anxiety.
It's for that reason that we combined a carefully considered blend of proven cannabinoids in our mints. Our Relief Mints, for instance, contain 2.5mg of THC, CBD, and CBG—along with complementary extracts—in each mint, while our Zen Mints combine a high dose of CBD with a low dose of THC to deliver a relaxing, balancing effect.
If you’re considering using cannabinoids for pain management, speak with your doctor first, don’t stop taking any prescription medications, and start with a low dose.
Summary: Can Cannabinoids Help to Manage Pain?
In Marijuana as Medicine? The Science Beyond the Controversy, Janet E. Joy and Alison Mack note that the nerves that detect pain are full of cannabinoid receptors and that these receptors seem to block pain during animal testing.(11)
They also write that the mechanisms through which cannabinoids block pain are different from those used by opioids, suggesting they could be used in combination. It could, theoretically, mean that patients can reduce opioid consumption—thus reducing the associated side effects and risks—without missing out on their pain-killing properties.
As noted above, though, we still don’t know for sure how cannabinoids work or even if they reduce pain. But we’re learning more about the benefits of these compounds all of the time, and there are countless anecdotal reports that suggest cannabinoids really can work wonders in this department.
So, whether you’re struggling with chronic pain or dealing with niggling issues, consider trying some cannabinoids to see if they work for you.
References
- https://oag.ca.gov/medicinal-cannabis
- https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-023-00207-7
- https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30110-5/fulltext
- https://www.liebertpub.com/doi/abs/10.1089/acm.2013.0190
- https://journals.lww.com/pain/fulltext/2019/04000/an_experimental_randomized_study_on_the_analgesic.11.aspx
- https://pubmed.ncbi.nlm.nih.gov/24117398/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204604
- https://pubmed.ncbi.nlm.nih.gov/29579828/
- https://www.sciencedirect.com/science/article/pii/S0926669024003364
- https://pubmed.ncbi.nlm.nih.gov/3169967/
- https://www.ncbi.nlm.nih.gov/books/NBK224384/
