A guide to cannabinoids for neuropathic pain

The role of cannabinoids in treating neuropathic pain

Cannabinoids hold great promise in treating neuropathic pain. To fully explain this, we need to dive into the endocannabinoid system. 

The endocannabinoid system (ECS)

Only discovered in 1988, the ECS is the largest regulatory network in humans (and all mammals). Our endocannabinoids interact with two specific receptors (CB1 and CB2) to produce a range of functions, including pain modulation, neuroprotection, and inflammation control. It is thought to be responsible for maintaining homeostasis, or balance, in the body.

Phytocannabinoids are named as such because they also hold the ability to bind to these same receptors (CB1 and CB2) in our endocannabinoid system. It is this binding of phytocannabinoids to the ECS that is thought to be responsible for the potential relief of neuropathic pain. They may also be able to interact with other regulatory networks, such as the serotonin and dopaminergic systems, which have been linked to pain control.

Research has also shown that cannabinoids (and other cannabis compounds like terpenes and flavonoids) can work together to produce a synergistic effect, which further increases their effectiveness. This is referred to as the “entourage effect”, and while still a theory, recent research is certainly pointing in its direction.

The effects of cannabinoids on pain pathways 

Due to the almost century-long prohibition and stigmatisation of cannabis, research into the potential medicinal benefits is still in the early stages. Thankfully, in large sections of the globe, the political and social climate surrounding this wonderful plant has been slowly changing in the past two decades. With this shift has come much broader access to funding for research, which has led to tremendous advances in the understanding of how cannabinoids interact with our bodies, particularly when it comes to pain pathways.

One study found that cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. Future research will explore the interaction between cannabinoids and specific receptors in order to develop novel therapies. 

One study found that cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. The paper concludes that certain nonpsychoactive cannabinoids, such as cannabidiol (CBD), may suppress chronic inflammatory and neuropathic pain without causing analgesic tolerance.

Another paper, while not specifically focusing on nerve pain, also showed the huge promise that cannabinoid therapy may offer. The paper concludes that Cannabidiol (CBD) has beneficial pharmacological effects, including anti-inflammatory and antioxidant properties, and has therapeutic potential for many diseases associated with oxidative stress.

A 2022 review highlighted a lack of clinical research investigating cannabis by routes other than oral and inhalation as a potential treatment for neuropathic pain. There is a need for clinical trials to assess if cannabinoids administered by diverse routes of delivery can effectively treat neuropathic pain.

The last piece of scientific evidence we will focus on in this article is this study. Researchers found that anti-pain and anti-inflammatory properties of THC, β-caryophyllene and β-myrcene (two of the terpenes that are produced my cannabis) combine and may create an optimal biochemical synergy for pain reduction. 

This study and many others highlight the potential to optimize cannabinoid and terpene profiles, dosing, and patterns of use for alleviating chronic pain.

How do cannabinoids stack up against conventional approaches?

Some common conventional approaches to nerve pain treatment include pharmaceutical medication, including opioids and anti-inflammatories. Acupuncture, massage, and herbal medicine are also often used. 

Direct comparisons are hard to make, and can be misleading. Medicinal cannabis should always be seen as one small part of a holistic therapeutic plan, and never as a stand-alone treatment option.

Safety and side effects

Medicinal cannabis has been proven, time and again, to be an extremely safe therapeutic option, especially when compared to some of the many pharmaceutical alternatives available.

The most commonly reported side effects from cannabis are dry mouth, increased appetite and drowsiness. As with any drug, there are potential risks and side effects associated with the use of cannabis. It is important to consult a medical professional before using cannabis for therapeutic purposes. 

Potential side effects of high doses of THC include:

• Red eyes
• Increased heart rate
• Anxiety
• Memory impairment
• Dizziness
• Loss of coordination

Potential side effects of high doses of CBD include:

• Diarrhoea
• Dry mouth
• Fatigue
• Reduced appetite

Cannabinoids can interfere with the normal activity of medications, so it is important to discuss your health condition and current medications with your prescribing physician. 

There is potential for patients to become overly reliant on cannabinoids. It is possible for patients to build up a cannabinoid tolerance in which the patient finds the usual doses no longer subdue the pain as effectively. 

The legal status of cannabinoids in the UK

Currently, recreational cannabis remains illegal in the UK. CBD products are widely available in health stores and online, however, it is significant to be aware that their efficacy can vary drastically from one product to another.

Medical cannabis became legal on the 1st of November 2018. Access is restricted to patients who have obtained a prescription from an approved specialist. 

Forms of administration

Cannabinoids can be administered by inhalation, edible, or tincture form according to UK law.

Each administration method comes with its own set of pros and cons, and depending on the health issue being treated and individual preferences, one or more of these methods may be recommended.

Inhalation: This is the most common form of administration and is preferred by many patients due to its rapid onset of action. It is important to note that the inhalation of vapour may irritate the bronchial passages and lead to coughing.

Edibles: Edibles are a convenient form of administration, however, they can take a long time before the effects are felt. The availability of the cannabinoids present in edibles is reduced when compared to other methods of administration, due to the digestive process.

Tinctures: This form of administration is becoming increasingly popular in the UK, due to its convenience and rapid onset of effects. Tinctures are taken sublingually (under the tongue) and the cannabinoids are quickly absorbed into the bloodstream.

Conclusion

Neuropathic pain can be unbearable, but cannabinoids offer patients a potentially effective and gentle method of alleviating pain and inflammation. They also may promote a sense of calm and better sleep, which are two critical factors for managing pain. 

The research is continuing to uncover the potential of cannabinoids, and how they interact with specific receptors. There are a variety of administration routes available, and understanding which one works best for you is an important part of the process.

Before taking any form of cannabis, it is essential to consult a medical professional. It is critical to ensure that your chosen form of cannabis is of high quality and contains the desired concentrations of cannabinoids. Medicinal cannabis is subject to much heavier regulation than over-the-counter options, and so quality and safety is assured.

Cannabinoids may offer a safe, effective, and natural way to potentially manage neuropathic pain. It is important to be aware of the potential side effects, and discuss with your doctor if medicinal cannabis is a suitable option for you.

Releaf understands the importance of medical cannabis in treating various medical conditions. With our tailored monthly packages, specialist consultations for medical cannabis, and a unique medical cannabis card for protection, you can access the treatment you need without worrying about the stigma.