Cannabis and Hemp as Treatment for Pain

There are many options to treat pain and disease in medicine today, for example commonly used medications in South Africa include over the counter aprin, paracetamol, panado, codeine to name a few, but also your more serious painkillers like Non-steroidal anti-inflammatories, opioids, gabapentin, and your steroids like cortisone.  We are all aware that there are side effects with long term, or inappropriate use with these medicines, and therefore should use them with caution.  Combining certain medications under medical supervision, also taking into account the condition that you are treating for, we can make use of the principle of synergy, where you get a bigger effect, using less.      There are also alternative therapies available like acupuncture, herbs, homeopathy, food therapy and essential oils that can be used in conjunction with the above medications to great effect.  As a practicing veterinarian with a holistic approach, I have used and combined several of these therapies over the years and some with great success.  The best outcome is achieved when patient’s conditions and treatment protocols are individualized, and monitored and adapted as needed through their disease process.

There are a few basic rules that I adhere by:

Firstly, do no harm, there is no substitute for good basic diagnostics,

Prevention is better than cure,

The response of the patient to the regime should be your guide to individualised management,

The use of medical cannabis or hemp has been used in modern human for quite some time, and is slowly starting to take its place in animal medicine as well.  There is still unfortunately a lack of research and regulation of products and protocols, but that seems to be changing over the last couple of years.  We will start by looking at the Endocannabinoid System.

Our Natural Healer: The Accidental Discovery

Your body has many important systems working separately and together, at any given moment. Just as an example, your immune system controls and regulates your ability to defend against infection. Your Cardiovascular System (CVS) regulates your heart rate, blood pressure, blood vessels, and your blood itself. The Respiratory System regulates breathing mechanisms, including working with your airways, lungs, and coordinating with the Cardiovascular System through the blood vessels.

Thanks to pioneering research from the late 1980s and early 1990s, the Endocannabinoid System (ECS) was discovered.

Researchers accidentally stumbled upon what we now know as our Endocannabinoid System (ECS) while studying the medicinal applications of cannabis. Through this research, scientists first saw that there are naturally occurring neurotransmitters that respond to a specific chemical component of cannabis—THC (Tetrahydrocannabinol). These neurotransmitters—later identified as cannabinoid receptors—turned out to be the most abundant type of neurotransmitter receptor within the human brain.

​In fact, cannabinoid receptors have since been found throughout the entire body, most notably seen in organs such as your lungs, kidneys, liver, and in your immune cells. They are present throughout your central nervous system (CNS).

​Though the discovery of the ECS is so recent, it’s been around for millions of years. Experts speculate that the ECS has been present within mammals for upwards of 500 million years.

​Since its ground breaking discovery, the ECS has been continuously studied and shown to be responsible for homeostasis in your body. Maintaining homeostasis is the most critical responsibility of the ECS. Its job is to facilitate ongoing harmony within the body, even in the face of changes in our environment.

​There are several factors that can impact homeostasis at any given point. Among those factors are our eating habits, consistency of exercise, environmental toxins, sleep hygiene, levels of stress, digestion, and the list goes on. If any of these factors become out of balance, the risk of disease and discomfort within the body increases.

In addition, our ECS is also heavily responsible for the processes of repair and protection.

The Sacred Plant: A Brief History & Understanding

Cannabis Sativa is the proper biological classification of the overarching species. Think of apples. Apples is the species of fruit. Within that species, there are many different types of apples ranging in color, taste, smell, size, etc. Same with trees. Tree is the species of plant, but within that species there are hundreds of subspecies or types of trees. Within the Cannabis Sativa species, there are 3 main separate subspecies: sativa, indica, and ruderalis (hemp). These subspecies are determined according to the specific, differing levels of constituents and molecules within each plant.

The three main constituents, or chemical make-up of the plant, consist of:

Phytocannabinoids/ Cannabinoids: Compounds unique to the Cannabis Sativa plant species. Each cannabinoid has its own level of effect on the human body through your body’s ECS.

  • : These compounds are the “essential oils” of the plant. Terpenes have complementary effects to cannabinoids, as well as other benefits. They occur in a variety of plants, vegetation, and fruits and have a distinct, strong aroma and flavor profile.
  • : Considered some of the largest groups of phytonutrients found within plants. They give color to fruits and vegetables. Research continues to explore the value of these compounds but they are known to be beneficial, especially when working in harmony with other phytonutrients.

What makes the sacred plant truly unique is its ability to work within the ECS. This capacity is directly related to the cannabinoids found in Cannabis Sativa.

4 Ways Cannabis & Hemp Can Help With Pain

  1. Regulating Inflammation

Research shows the following cannabinoids and terpenes as having anti-inflammation characteristics: CBD CBDa THCa CBGa CBC Myrcene Limonene Humulene Caryophyllene Delta 3 Carene

For best results, experts recommend using whole plant applications due to the Entourage Effect. The entourage effect is the combined interaction of all the plant constituents—cannabinoids and terpenes, working in unison to increase effectiveness. This also brings about side benefits and fewer adverse effects.

When using a whole plant application, less is more, as well. This often leads to positive results at much lower dosages

  1. Reducing the Overall Pain Response
  2. Helps Other Medications to Work Better

Despite decades of research and efforts to treat chronic pain, pharmaceutical options are sometimes not effective, and many are known to have negative side effects, create dependent cycles, and even lead to severe addiction or death.

Cannabis and hemp are able to help in a couple of ways. First, they reduce the pain response and secondly, they can work in tandem with other medications, allowing doses to be significantly lowered. In one study, researchers saw a 64-75% reduction in opioids in patients who added medical cannabis to their treatment. They also reported the complete discontinuation of opioid use in 32-59.3% of chronic non-cancer pain patients.

  1. Improved Quality of Life

There are several direct and indirect ways cannabis and hemp can help improve quality of life for both humans and animals. This, in turn can make a big difference in your pain tolerance, and overall ability to manage your pain. Some examples include: Mood Elevation—If your mood is good, you will naturally have more optimism about overcoming your pain challenges. For example, the relief hemp and cannabis can offer can help you to feel less irritable. Likewise, they both can contribute to a reduction or even elimination of anxiety and depression. Mobility and Exercise—Living a sedentary life is damaging to your health. Unfortunately, when you are in pain the last thing you want to do is exercise. Getting out and about may be very uncomfortable, even impossible.

Better Sleep—Everyone knows how important sleep is. When you are in pain, sleep may be a challenge. Not sleeping can lead to or make worse health issues that may contribute to pain. It’s a vicious circle, but cannabis and hemp can help.

As always, best results come from a whole plant product, wherever possible. You want to make sure you are getting as many terpenes, flavonoids and cannabinoids as possible in order to achieve these side benefits to taking cannabis and hemp for pain.

Dosage recommendations for Animals

  1. If possible work with your veterinarian, and supplier or product that is known by your veterinarian.  There are some concerns when starting to use a whole product when an animal is already on other medication for example phenobarbitone or CNS suppressants.
  2. Cannabis is not a miracle cure, therefore micro dosing before big problems arise with intermittent pulse dosing has always worked well for my patients.
  3. As far as possible use a product that has been tested and is as far as possible manufactured consistently and Dilutions factors are very important when it comes to animals for the sake of accuracy and consistency in dosing
  4. Most importantly is to start on a very low dose, and taper dosage up or down according to your animal’s Like humans, animals have different responses to cannabis, and it is therefore very difficult to predict the effective dose used initially.  I advise to slowly taper the dosage up over several days to weeks, keep it stable according to the condition, and then taper it down again when a steady state has been reached.  Intolerances happen due to the fact that the ECS is activated after a while, and the exogenous cannabis may then cause side effects.  Intermittent pulse dosing is then a rather preferable approach.

Dr Marisa Slabber BVSc, CVA, MSc


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