How cannabis and psilocybin could help some of the 50 million Americans who are experiencing chronic pain

As an assistant professor of anesthesiology and a pain researcher, I study alternative pain management options, including cannabis and psychedelics.

I also have a personal stake in improving the treatment of chronic pain: In early 2009 I was diagnosed with fibromyalgia, a condition characterized by widespread pain throughout the body, sleep disturbances, and generalized sensory sensitivity.

I see cannabis and psilocybin as promising treatments that may contribute to meeting that need. Given that an estimated 50 million Americans have chronic pain – meaning pain that persists for three months or longer – I want to help you understand how cannabis as a potential tool for pain management and How to use psilocybin effectively.

Cannabis vs. Other Pain Medications

Cannabis, also known as marijuana, is an ancient medicinal plant. Cannabis-based medicines have been used for at least 5,000 years for applications such as arthritis and pain control during and after surgery.

This use spans from ancient times to modern times, with contemporary cannabis-based medications being used to treat some seizure disorders, to promote weight gain for HIV/AIDS-related anorexia, and to treat nausea during chemotherapy. For.

Like anything you put into your body, cannabis poses health risks: driving under the influence can increase the risk of accidents. Some people develop cyclic vomiting, while others develop motivation or dependence problems, especially with heavy use at a younger age.

That said, fatal overdose from cannabis is almost unheard of. This is remarkable considering that approximately 50 million Americans use it every year.

In contrast, opioids, which are often prescribed for chronic pain, have contributed to hundreds of thousands of overdose deaths over the past few decades. Even common pain medications like nonsteroidal anti-inflammatory drugs like ibuprofen cause thousands of hospitalizations and thousands of deaths each year from gastrointestinal damage.

Furthermore, the effectiveness of both opioid and nonopioid pain medications for treating chronic pain is limited. Medications used for chronic pain may provide minor to moderate pain relief in some people, but many ultimately cause side effects that outweigh any benefits.

These safety issues and limited benefits have led many people suffering from chronic pain to use cannabis as a chronic pain treatment option. Indeed, in survey studies, my colleagues and I have shown that people often use cannabis in place of painkillers because cannabis has fewer negative side effects.

However, more rigorous research is needed on cannabis for chronic pain. Until now, clinical trials – considered the gold standard – have been short in length and focused on small numbers of people.

Furthermore, my colleagues and I have shown that these studies employ medications and dosage regimes that are very different from how consumers actually use products from state-licensed cannabis dispensaries.

Cannabis also produces recognizable effects such as euphoria, altered perceptions, and divergent thinking, so double-blind studies are difficult to conduct.

Despite these challenges, a group of cannabis and pain experts published a proposed guideline for clinical practice in early 2024 to synthesize existing evidence and help guide clinical practice .

This guideline recommends that cannabis products be used when pain is associated with sleep problems, muscle spasms, and anxiety. These multiple benefits mean that cannabis could potentially help people avoid taking a separate medication for each symptom.

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