Anecdotal evidence suggesting that medical cannabis helps prescription opioid users reduce their dependence on the more addictive medications isn’t hard to come by. It is everywhere. As for a biological and physiological explanation, not so much. But recently, a pharmacology scientist from the University of Washington offered a reasonable proposal.
Research Associate Professor of Pharmacology Benjamin Land proposes that cannabis interacts with the body’s built-in endocannabinoid system to provide a pain relief experience similar to what patients experience with actual opioids. If his proposal proves scientifically accurate, it could completely change the way we view medical cannabis as a drug for treating both acute and chronic pain.
A Natural Opioid System
Without getting into all the finer details, Land proposes that the human body has its own built-in opioid system similar to the human endocannabinoid system. He proposes that endorphins, the chemicals known to create pleasurable feelings in the human brain, are also natural opioids.
All opioids, whether naturally occurring or synthetic, offer pain relief by binding to certain receptors. Everything from morphine to fentanyl achieve pain relief this way. The interesting thing is that the receptors in question are not limited to the brain. They exist throughout the body.
The unfortunate thing about those located in the brain is that they are also linked to the brain’s reward system. Thus, opioids that offer pain relief mainly by binding to brain receptors can trigger the reward system and lead to addiction. This is the big problem with so many prescription opioids.
Pain Relief Via the Endocannabinoid System
Land further proposes that cannabinoids binding to cannabinoid receptors throughout the body offer similar pain relief. The two primary cannabinoids in marijuana are THC and CBD. They bind to different receptors. This reality leads to yet another proposal.
Because the two cannabinoids bind to different receptors, it is proposed that combining them offers more effective pain relief than using just one or the other. Either way, binding to receptors inhibits the brain’s ability to interpret pain signals. This is the mechanism by which Land says both cannabis and opioids provide effective pain relief.
Land’s proposal is reasonable based on the current knowledge we have about THC and CBD. According to the experts at Utahmarijuana.org, an organization that supports medical cannabis patients in Utah, knowledge of the endocannabinoid system is pretty extensive. While science hasn’t fully uncovered all the implications of how cannabinoids interact with this particular system, we do know such interaction takes place.
Pain Relief Without the Addiction
Combining Land’s proposal with what organizations like Utahmarijuana.org say about cannabis may lead to the assumption that cannabis can offer pain relief without the addiction risk. Whether or not this is true may depend on how you define addiction.
Even the most robust cannabis advocates need to admit the existence of cannabis/marijuana use disorder (CUD). Furthermore, medical providers who specialize in medical cannabis acknowledge that patients often experience tolerance. They recommend that patients take regular breaks in order to decrease it.
Under the classic definition of addiction, the combination of MUD and tolerance suggests that addiction is possible. But subscribing to the modern definition of addiction would take cannabis off the table. At any rate, the risks associated with regular cannabis use pale in comparison to long-term opioid use.
We may be one step closer to understanding how marijuana accomplishes pain relief. It is quite possible that its mechanism is at least similar to the mechanism behind opioid pain relief. And if that’s eventually proven to be the case, medical cannabis could ultimately represent the end of the opioid crisis.