Choosing between therapeutic cannabis and opiates to treat chronic pain

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Chronic pain is a condition that is difficult to treat. The areas of the body that it affects and its origin can vary from person to person. In the recent years people have been treating themselves with opiates. These drugs are very effective, but can lead to a long-term dependence, which is partly due to its misuse. Several studies have indicated that patients with chronic pain are more likely to misuse prescribed opiates, which can result in range of negative side effects.[1]

Although addiction is one of the most serious risks associated with opiates, it has also been shown that they can cause higher levels of depression and anxiety in patients with chronic pain, than other drugs. A study by Harvard University and several institutions in Barcelona showed that 54% of patients with chronic pain suffer from depression and 50% suffer from anxiety[2]. Studies on the treatment of chronic pain are focusing on finding an alternative to opiates.

At the start of 2017, an Israeli study compared the use of opiates and cannabinoids to treat anxiety and depression induced by chronic pain. The study lasted for 6 months with almost 900 participants answering questions about their medication use and pain intensity, their medical records and socio-demographic elements were also taken into account.

After the data was processed, each patient was divided into three groups according to the intensity of their depression and anxiety and according to their type of treatment. The three groups consisted of those who only used opiates, those who only used medical cannabis and those who used both. The results showed that opioid users were more likely to develop depression and anxiety as a result of their chronic pain[3].

Today we know that the actions of the cannabinoid receptors are linked to the reduction of depressive tendencies[4]. However the factors that cause the use of therapeutic cannabis to decrease depression and anxiety have not yet been well explained. One possibility that has been studied is the fact that cannabidiol neutralizes the anxiety that THC can produce. In any case, this has only been proven in healthy subjects [5].


[1] Feingold, D., Goor-Aryeh, I., Bril, S., Delayahu, Y., & Lev-Ran, S. (2017). Problematic use of prescription opioids and medicinal cannabis among patients suffering from chronic pain. Pain medicine, 18(2), 294-306.

[2] Gadermann, A. M., Alonso, J., Vilagut, G., Zaslavsky, A. M., & Kessler, R. C. (2012). Comorbidity and disease burden in the national comorbidity survey replication (NCS‐R). Depression and anxiety, 29(9), 797-806.

[3] Feingold, D., Brill, S., Goor-Aryeh, I., Delayahu, Y., & Lev-Ran, S. (2017). Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana. Journal of Affective Disorders, 218, 1-7.

[4] Degenhardt, L., Lynskey, M., & HALLY, W. (2000). Cohort trends in the age of initiation of drug use in Australia. Australian and New Zealand journal of public health, 24(4), 421-426.

[5] Zuardi, A. W., Shirakawa, I., Finkelfarb, E., & Karniol, I. G. (1982). Action of cannabidiol on the anxiety and other effects produced by Δ 9-THC in normal subjectsPsychopharmacology, 76(3), 245-250.

About Maria E

Lic. en Periodismo. Especializada en periodismo médico y aunando la pasión por la ciencia y la informacíon especializada. Experta en cannabinoides, escribe sobre las últimas investigaciones sobre cannabis medicinal y sus aplicaciones terapéuticas. En mi trabajo, me dedico a fondo para tener fuentes válidas y cuenten con un trasfondo científico serio.

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