The legalization of marijuana has been highly contested in Canada but new research suggests doing so could improve the lives of pain sufferers.
The study shows more than half of participants were able to get off heavier prescription drugs with the use of cannabis as a pain management tool.
Dr. Mark Ware, Associate Professor in Family Medicine at McGill University and Executive Director of the non-profit Canadian Consortium for the Investigation of Cannabinoids (CCIC) says cannabis has emerged as a way to manage pain but now we have to wait for science and policy to catch up.
“I’m hoping that with changes in legislation and with changes in regulations, with what is, I think an opening up of our minds of towards thinking of cannabis in a different way, that that will come with additional research.”
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But he says cannabis seems to be more effective with certain types of pain.
“There are pain types that are caused by nerve injury. This could be peripheral nerves like trauma surgery where you get damage to a nerve. Or central, multiple sclerosis, people with spinal cord injury where the injury to the nerve is more central and it appears that something about those kinds of chronic pain states that are more responsive to cannabinoid therapy.”
Dosage: How much is enough?
Ware says research shows we have a long way to go in terms of being able to advise patients on dosage.
“Physicians and health professionals as of now really don’t have much information to be able to give to the patient about what would be a standard prescription profile.”
He says over the past decade or so it has become a more reliable product that contains a stable amount of active ingredients.
“But we still haven’t been able to figure out exactly what in terms of the active ingredients in there. What is the actual amount I need to take in order to control my pain?”
‘We need to do this’
“I don’t think it’s a question anymore of whether we should, it’s how are we going to do this and how are we going to do it in the context of, in some areas, limited information. In some areas, we know quite a lot more than many people realize.”
Ware says there are ‘reasonably deep bodies’ of data and experiences experts, including himself, are learning from.
“It’s not like were going in completely blind but I think what we have learned is if we are going to do this and it appears as if we are, that we should do it in a way that allows us to learn as we go.”
Researchers are probing for answers, learning from experiences and adjusting theories in order to inform policies going forward.
“Flexible enough to be able to adapt but responsive to new information.”
In the study, researchers found they couldn’t be sure on how the use of cannabis has changed people’s pain because there was no baseline.
Ware stresses the importance of having a ‘pain base,’ full of data on things such as hospital visits and car crashes.
He says if there aren’t methods in place early, researchers won’t know how to interpret results as they come in.
“What we learn, we will need to share in the same way Colorado shared with us. We will need to share this with other countries around the world.”
Need to know
When prescribing pain relief Ware says first he has to look at patients’ lifestyle and not prescribe medication without just cause.
For example, treating someone’s sleep deprivation could be the cure to their pain.
“Pain doesn’t happen in a vacuum, pain happens to somebody with a light and understanding how that pain is affecting their sleep, their mood, their family, their job, getting a very holistic vision of how pain is affecting them really helps you understand what aspects of pain you need to start addressing and treating.”
He says overprescribing is an ongoing issue but that a number of people and organizations in B.C. are moving away from this approach.
“We may be creating all kinds of problems that downstream cause all kinds of effects on society. So by doing the same thing with cannabis would be just sort of fall into the same trap where we don’t just want to knee-jerk react to a pain patient.”
He says we need to make sure we evaluate patients in context and admits cannabis isn’t for everyone.
“It’s something that has to be done in a carefully considered way and with as much information as both the professional and the patient can have together and make an informed decision.”
Ware says it’s a multi-model approach that “works best for anybody coming in with a pain problem.”