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    Move Over Advil—Why Mother Nature's Chill Pill Is The Best Thing For Pain

    TLDR;

    • An estimated 50 million U.S. adults live with chronic pain, sparking a massive need for safe, effective, and non-addictive treatment options.https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm
    • One solution: cannabis and terpenes. These compounds have been shown to relieve pain in very different yet effective ways.
    • CBD and THC relieve pain and inflammation, much like NSAIDs. They may also block pain signals similar to opioids. 
    • Certain terpenes reduce inflammation and can also block pain signals.
    • Get the details about how to find the right cannabis product for your pain.

    You don’t realize what it’s like to live with chronic pain until you can no longer easily do the things you’ve always done. Or until it's gone, and then returns, and you realize how much it hurts to just ... move. 

    Pain sits with you and follows you around all day long like a panting dog. Pain is a constant nudge. It's a thorn in your side, a splinter in your skin. It's a reminder that living can be agonizing, and pain will rear its ugly head whenever you reach up, stretch out, breathe or even just exist. 

    Pain is part of the reason we're deep in the trenches of the opioid overdose crisis. Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them because opioids are addictive, and the discomfort can be constant. 

    An estimated 50 million U.S. adults live with chronic pain. It’s one of the most common reasons adults seek medical care, and it’s linked to opioid dependence. Government agencies like the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services (HHS) are focusing on the advancement of safe, effective, non-addictive treatment options to manage chronic pain. 

    But one potential solution has been quietly growing all along: plant medicine. Namely cannabis and terpenes.

    Early research into the effects of cannabis compounds and terpenes could transform the way we think about pain management. In the coming years, we'll begin to more clearly understand how cannabis and terpenes can help you recover from an injury, manage pain, and feel more like yourself without the same risks as opioids. Here's what we know (so far) about pain, cannabis, and plant compounds, plus what the future looks like for safer pain management.

    What are the different types of pain?

    Pain means that something may be wrong. It can be a dull headache or a sharp, shooting sensation in your back. It can cause other symptoms, like nausea or anger. Sometimes, pain is annoying. Other times, it’s debilitating. There are many different reasons a person might feel pain — and sometimes, finding the cause is a battle all its own. 

    Acute painis short-term pain that happens suddenly and has a specific cause.Chronic pain lasts longer than six months — even after the injury has healed. There are three different ways acute and chronic pain can be classified:

    • Neuropathic pain:Caused by damage or disease that affects your nervous system. It can feel like numbness, hypersensitivity, or tingling.
    • Nociceptive pain: The pain most people are familiar with. This pain comes from injury to your tissues and bones, like back pain, nausea, and stubbing your toe.
    • Inflammatory pain:Inflammation happens when your body responds to harmful stimuli, like germs or toxic compounds. This response can make the tissue feel sensitive and painful. Examples include appendicitis, rheumatoid arthritis, and inflammatory bowel disease.

    Pain doesn't always fit into a single category. Inflammatory pain can overlap with nociceptive pain. Some types of pain, like migraines and fibromyalgia, aren't easily classifiable because they're not entirely understood. Many people use pain relievers (analgesics) to manage their symptoms. These pain relievers can affect your body and brain in vastly different ways.

    Common types of pain relievers

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Reduce inflammation by blocking the production of chemicals that promote inflammation, pain, and fever. These chemicals are called prostaglandins.
  • Acetaminophen: May block cyclooxygenase (COX) enzymes, which help to form prostaglandins. Unlike NSAIDs, acetaminophen doesn’t reduce inflammation. Fun fact: Researchers still aren’t surehow acetaminophen works.
  • Narcotic analgesics (opioids): Activate opioid receptors on nerve cells, blocking pain messages sent from the body to the brain.

  • Knowing what kind of pain you have can help you decide how to treat it. If you have a muscle sprain, acetaminophen isn’t going to help reduce inflammation. NSAIDs can help reduce a fever. Doctors prescribe opioids because they tell your brain to block pain.

    But what about cannabis and terpenes?

    How Cannabinoids and Terpenes Address Pain

    The cannabis plant contains more than 110 cannabinoids and 120 terpenes. These compounds can help relieve pain and reduce inflammation — without the addictive side effects of opioids. 

    Cannabinoids and Pain

    Cannabinoids are the chemical compounds that give the cannabis plant its therapeutic properties. The cannabis plant contains more than 110 cannabinoids, including two you might have heard of: CBD and THC. Cannabinoids help people manage conditions like pain, anxiety, and inflammation by binding to receptors in your body's endocannabinoid system. AKA the system that helps maintain balance in your entire body. 

    CBD is non-psychoactive, which means it doesn't get you high. Instead, CBD is used to help reduce pain and inflammation, improve your mood, and help you sleep. In animal studies, CBD applied on the skin can help lower pain and inflammation. Another study confirmed that CBD inhibits inflammatory and neuropathic pain. It does this by changing the way your neurons speak to each other. CBD inhibits pain signals from the brain to the bodyandreduces inflammation, which can contribute to acute and chronic pain.

    Like NSAIDs, CBD, THC, and other cannabinoids have been shown to target cyclooxygenase enzymes. These are the same proteins that produce prostaglandins — the chemicals that promote inflammation, pain, and fever. And like opioids, cannabinoids block pain signals from your brain to your body. However, the way this happens is different: opioids bind to opioid receptors, while cannabinoids bind to cannabinoid receptors (CB1 and CB2) in your endocannabinoid system to block pain signals.

    CBD can be effective solo, but it works even better when it's paired with THC and terpenes. That's because CBD changes the way THC interacts with your endocannabinoid system, a concept known as the entourage effect. Terpenes round out the benefits, changing the way CBD and THC work in your body — and providing pain relief on their own.

    Terpenes and pain

    Terpenesare compounds that give plants their aroma and flavor, like the bright citrus zing of an orange and the soothing scent of lavender. Terpenes are associated with benefits all their own, including antioxidant, anti-inflammatory, and anti-tumor properties.  Terpenes are present in many plants. Still, they're often connected to cannabis because the cannabis plant has one of the most complex terpene profiles. That means it has atonof terpenes — and more significant potential for medicinal benefits. 

    Terpenes are also effective plant medicine on their own, whether you want to sleep better, manage pain, or reduce anxiety. Many terpenes have been shown to have pain-relieving properties. Like cannabinoids, they work by crossing the blood-brain barrier and acting in the central nervous system. Researchers are still investigating exactlyhowterpenes help reduce pain. Some terpenes, like myrcene and limonene, reduce inflammation. Other compounds, like menthol, actually interact with opioid receptors to relieve pain.  One of the most commonly studied terpenes, beta-caryophyllene, is unique because your body treats it like a cannabinoid. That means beta-caryophyllene binds to CB2 receptors, which means it can support the treatment of inflammation and pain — without having to use CBD or THC.

    In response to the opioid crisis and the need for more effective and safer pain management options, the National Institutes of Health (NIH) isallocating approximately $3 million toward research that investigates the potential pain-relieving properties of cannabis compounds, including both cannabinoids and terpenes. More importantly, the nine research projects funded by the NIH will investigatehowthese plant compounds operate in the body, which will help inform future advancements in non-opioid pain management.

    In the meantime, if you’re looking for alternative options for pain relief, you can experiment with cannabis products on your own.

    How To Find The Right Cannabis Product For Pain

    Depending on your location, you may be able to go into a dispensary and speak directly with a budtender. If you want to get high, they’ll recommend products that are higher in THC — and this isn’t limited to blunts and vapes. Many cannabis products are also available as edibles, tinctures, oils, and creams. If you’re looking for strictly pain relief without getting stoned, your budtender will recommend products with higher percentages of CBD. You still wantsomeTHC in there, but just enough to support the entourage effect — and not enough to get high. You have options.

    This is important:If you’re buying CBD products online or in major big-box retailers, you might not get the same pain-relieving qualities. Here’s how to tell the difference between CBD and hemp seed oil.

    Terpenes For Pain Relief

    You can also try cannabis products that are made with combinations of terpene (called terpene profiles) to support pain relief. Terpenes complement cannabinoids, which can give you better therapeutic effects than CBD or THC alone. That's why you'll find some cannabis strains that are higher in specific terpenes. In terms of pain relief, here are a few particular terpenes to look for:

  • Valencene: Anti-inflammatoryhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007308/ 
  • Myrcene: Muscle relaxant and sedativehttps://www.sciencedirect.com/science/article/abs/pii/S0024320505009811 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195130/ https://www.sciencedirect.com/science/article/abs/pii/S0944711304701786 
  • Beta-Caryophyllene: Anti-inflammatory and pain reliefhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2449371/pdf/zpq9099.pdf
  • Bisabolol: Anti-inflammatory and pain reliefhttps://aocs.onlinelibrary.wiley.com/doi/abs/10.1007/s11746-009-1483-3 
  • Limonene: Anti-inflammatory and antioxidanthttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0092122 http://www.koreascience.or.kr/article/JAKO201332479511448.page 
  • Linalool: Anti-inflammatory
  • https://www.ncbi.nlm.nih.gov/pubmed/12587692  

     

    Unlike cannabis, terpenes won’t get you high — instead, they have medicinal qualities all on their own. You can use terpene products to sleep better,[LINK] manage anxiety,[LINK] and, yeah, reduce pain. Get the facts about terpenes here.

    The Bottom Line About Cannabis, Terpenes, and Pain

    Chronic pain is debilitating. And for many people, opioids are one of the only ways to find enough relief to get through the day. Research into the ways cannabis and terpenes can relieve pain is still in its early days, partially because of politics and also because we're just beginning to understand how beneficial plant medicine can be. 

    Pain may always be a part of life, but that doesn't mean your choices are limited. New conclusions about the power of cannabis and terpenes reinforce the fact that you have options (but talk to your doctor before you make any significant changes). What matters is that cannabis products can and should fit into the conversations happening about pain management. 

    You can get high or not get high. 

    You can use CBD for targeted pain relief or smoke cannabis with high levels of myrcene for total relaxation.

    You can use terpenes just for pain or use terpenes that promote sleep and calm. 

    You can choose your own cannabis adventure thanks to the world of plant medicine that Mother Nature has created — and when you think about it, that’s pretty amazing.