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Is Cannabis Better for Chronic Pain Than Opioids?

August 15, 2016
Chronic pain can be an incredibly debilitating condition. For many who live with it on a daily or near daily basis, the condition can be so oppressive, it affects other parts of their lives, impacting their mood, health, and overall well-being. Unfortunately, many treatment options are only nominally effective. Worse, commonly prescribed drugs like opioids are highly addictive and potentially toxic; 28,000 people died from an opioid overdose in 2014, more than any other year in history. No wonder a growing number of the estimated one in five Americans who suffer from chronic pain are turning to cannabis as an alternative.

While many people believe cannabis to be an effective treatment, what does the science say? Is it really more effective and safer than other drugs? Fortunately, when it comes to cannabis and cannabinoid-based formulations, chronic pain is one of the best studied conditions. However, the causes of chronic pain are diverse. Moreover, chronic pain can be nociceptive or neuropathic. Nociceptive pain is caused by tissue damage or inflammation. Neuropathic pain is caused by nervous system damage or malfunction.


This Medical Cannabis Researcher Explains How Marijuana Can Combat the Opioid Epidemic

Everyone’s biology is unique and will respond differently to cannabis depending on a number of variables, including what type of chronic pain they experience, dosage, strain, and administration method (vaping, edibles, tinctures, etc.).

How Effective is Cannabis for Chronic Pain Relief?

In a comprehensive, Harvard-led systematic review of 28 studies examining the efficacy of exo-cannabinoids (e.g. synthetic formulations or cannabinoids from the plant) to treat various pain and medical issues, the author concluded, “Use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high quality evidence.”

Of the studies reviewed, six out of six general chronic pain studies and five out of five neuropathic pain studies found a significant improvement in symptoms among patients. Notably, while most of the studies were limited to synthetic preparations of cannabinoids, three of the five neuropathic pain studies investigated “smoked” cannabis, while two examined an oral spray preparation.


The different ways to smoke and consume cannabis

Dr. Donald Abrams, a professor and Chief of Hematology/Oncology at San Francisco General Hospital, supports cannabis to treat chronic pain, suggesting the following:

“Given the safety profile of cannabis compared to opioids, cannabis appears to be far safer. However, if a patient is already using opioids, I would urge them not to make any drastic changes to their treatment protocol without close supervision by their physician.”

Both THC and CBD in cannabis are known to elicit analgesic effects, especially when used together due to their congruent chemical synergies.

Cannabis vs. Opioids

North America has been hit hard by the opioid epidemic. Prescriptions have increased 400% percent since 1999, and with this trend a shocking increase in fatal overdoses has followed. Every day, 40 people now die from prescription narcotic overdoses. Many also move on to heroin because it is cheaper, easier to find, and more potent.

Could cannabis be part of the solution? Quite possibly. An increasing number of studies provide evidence that many patients can use cannabis instead of opioids to treat their pain, or they can significantly reduce their reliance on opioids.


Two New Studies Find Cannabis Reduces Opioid Prescriptions

A University of Michigan March 2016 study published in the Journal of Pain provides some compelling data. They found that cannabis:

  • Decreased side effects from other medications
  • Improved quality of life
  • Reduced use of opioids (on average) by 64%

“We are learning that the higher the dose of opioids people are taking, the higher the risk of death from overdose,” said Dr. Daniel Clauw, one of the study’s researchers and a professor of pain management anesthesiology at the University of Michigan Medical School. “[The] magnitude of reduction in our study is significant enough to affect an individual’s risk of accidental death from overdose.”

Kevin Ameling, a chronic pain patient who now works for a Colorado-based non-profit cannabis research advocacy group called the IMPACT Network, is a success story. Ameling believes cannabis saved him from a life of dependency on prescription drugs. In 2007, he suffered a severe fall and was prescribed a cocktail of prescription drugs that included OxyContin, Tramadol, Clonazepam, and Lexapro. The pain became so severe that he had to progressively increase dosage while the OxyContin became less and less effective.


America’s Opioid Crisis: Can High-CBD Cannabis Combat Pain and Reduce Addiction Rates?

Living in Colorado, he decided to try medical marijuana in 2013. He claims he achieved results immediately and was able to significantly reduce his prescription intake. He cut his OxyContin dosage by 50%, reduced Clonazepam from 3 mg to 0.5 mg, Lexapro from 30 mg to 5 mg, and Tramadol from 300 mg to 75 mg.

“It’s hard to express in words what a life changer medical marijuana has been for me,” said Ameling. “I was becoming increasingly worried about having to take higher doses of prescription drugs that can be highly addictive and toxic. Not only was I able to cut back significantly, with cannabis I can often skip the OxyContin with no adverse effects, something I couldn’t do before.”

Cannabis Can Take a Bit of Trial and Error

Ameling added, “Everyone will respond differently. For me, I found smoking can worsen my symptoms, while low dose edibles work the best.”

No doubt, the chemical composition of the strain you choose and how you consume will affect the outcome. It may take a little trial and error before you find the most effective cannabis strain, dose, and preferred method of administration for your pain. Most importantly, if you are currently using opioids, exercise extreme caution. A change in treatment protocol should be done under medical supervision.


A physician’s perspective on optimal cannabis dosing

And, finally, heed the advice of Dr. Michael Hart, head physician at Marijuana for Trauma in Canada: “When considering cannabis to treat chronic pain, the adage ‘less is more’ rings true. Patients seem to find more relief in indica strains which are higher in THC than most sativa or hybrid strains. What we’ve found is that these strains can be highly effective in low to moderate doses, but could actually make pain worse in higher doses. So it’s important to start low, and titrate up as appropriate.”

Jeremy Kossen's Bio Image

Jeremy Kossen

Jeremy is a contributing writer at Leafly. He is a best-selling author, podcaster, and entrepreneur.

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  • Rhonda Larson Byrne

    In 2011 i applied and was approved for Medical Marijuana in the state of Michigan due to chronic pain of lower back neck shoulder legs feet right arm and hand etc…due to 2-auto accidents neither was I at fault for …. i was 28 years young when I suffered from the first auto accident second 41 years young i am now 56 I ran the gauntlet of medical tests pills injections all just a bandaid no cure I was never fond of medications the side effects hit me harder than most people but i could take Darvocet fortunately this medication was taken off the market do to heart failure in patients lawsuits were filed that’s when I decided MM was the direction I would be taking…I follow the State of Michigan MM laws to the T …I do not want any problems with the law i just want a pain free quality of life … I’am my own MM caregiver I grow smoke make and eat my own edibles I adjust the % of thc and cbd’s in my meds in the summer fall and winter at bedtime I eat 1-EB night cookie if its a bad day i eat 1-day cookie and apply infused coconut oil all over my body before bedtime also during the day as needed …My quality of life has increased big time I thank God and all the wonderful people who have kept the cannabis plants alive God blessed the beautiful Cannabis buds to heal our bodies we need THC and CBD to heal our bodies …Good health and blessings to you all 😀

    • jagman

      You sound like you are my kind of person and someone to learn from.
      I am 80 yo, hip,leg, back so bad some days can’t get out of bed. Got my AZ card but dispensing shops here seem to be excuses for getting high which I prefer not to do as I don’t drink for same reason. I need to be always with a clear mind and in control. I refuse Opioids. I have tried the “drops” and a VAPEN but all they do is make me sleepy.
      BUT you seem to have found the answer so I would really appreciate your help and advise on:
      being a reformed smoker, use by non-smoking? Growing, best seeds and best place to buy….. Have lots of space, what about seeds? Variety for pain? I could go on and on so what advice can you give me? Links to edibles, growing, would be great…… etc. The shops here do not seems to have pills for pain. If I can find, are they better than the edibles? THANKS

      • Jessica Lambert

        Sounds like a balanced Hybrid strain [low on the euphoria effects] in an edible would be a great fit for what you need – Kat’s processes for edible canna-oil is linked below. She rambles a bit but it’s all very well researched information –
        She knows a lot about the subject matter of some of the other questions you have as well. – Hope it Helps! –

      • Stacie Marie

        It sounds to me like you only need to use the CBD tincture and topical cream. They have absolutely NO psychoactive effects and TONS of benefits! I’ve got Lupus, RA, fibromyalgia and lots of brain fog. CBD with help with pain and inflammation NOT THC.
        I sure hope this helps you!
        Sending Reiki energy your way,
        Stacie~Reiki Master energy healer ❤

  • Coach Nancy

    So check this out: Severe hip pain for 2 years to the point I couldn’t walk. Driving was painful too. Short story is no pain meds were ever prescribed unless I asked. All I asked for was a muscle relaxer — and the guy prescribed on used for fibro – which I do not have. I played guessing games as to what supplements, foods or otc stuff would help.

    I HAD NO IDEA! I thought all this hype was just an excuse to get high. I fought hard against reverting to old habits….. but when I asked my gynecologist what i might do for pain beyond ibuprofen, she and I proceeded to discuss weed for the rest of the appointment. She can’t even prescribe it, but is a total advocate.

    All I can say is it’s working. Lot’s to learn and understand. While I’m glad the docs didn’t go down the opiate road with me, I’m a bit frustrated that they didn’t seem to take the pain seriously. Very strange of them.

    Studying up on it now… and amazed that this information isn’t readily available.

    • Older_Dude

      I’m in the middle of stage 4, metastatic prostate cancer treatment consisting of a 4 week course of radiation 5 days a week and now on my third chemo infusion. At least three pain meds have been prescribed – Morphine, Norco & Gabapentin. I have been a pot smoker for over 50 years on a causal basis, never a heavy user. I got an MMJ card here in Cali and that gave me access to much more variety and potency than the former “baggie weed” I had been getting.

      This option has proven to be effective for me. I can pretty much eliminate all need for pain relief from prescription drugs by smoking about a gram ($20) or so a week. Very affordable and much less than the copay for the drugs! LOL YMMV

      When this all started a few month ago, I asked ALL my Doctors about MMJ use and they all agreed or did not object. On the other hand, NONE were willing to sign off or recommend MMJ “officially” for fear of the FEDERAL laws and Sched.I assignment, regardless of the State level laws in the state they are working in.
      This is a problem. Effectively, this forces those in need to deal with the sketchier avenues of getting “approved” by a licensed Doctor. Easily done online for less than $100 here. Only had one dispensary waffle about the fact that my “original” that they insisted on seeing didn’t have an “embossed seal” over the signature of the Doctor. (been fixed) To be fair, this place is known for how difficult they can be to get approved and are strictly “medical patient” focused. This is why I went there in the first place.

    • Kindred Kai

      Hi, Nancy!
      May I ask, what kind of hip pain did/do you have? And when it is the worst, what are you doing?

    • Joe lapera

      Hey nancy I’ve been self medicating for yrs I have Cronic pain it works excellent I will not give into the suits for ther poisin opiates. If getting stone is a side effect HA HA SO BE IT ITS BETTER THAN SOME SERIOUS SIDE EFFECTS O F THE SUITS PRODUCTS. TWIST UP BE HAPPY😍😍

    • E.L. Bl/Du

      Coach, I can speak from both sides, as a person in chronic pain and a former RN, and its not they dont take it seriously. Its a puzzle to treat however. Each practitioner also has their own way of going about it, different beliefs etc, so it can be a jungle out there to find the help you need and treatment you want to tolerate. Not many will prescribe cannabis due to their license being federally controlled. (They CAN but wont take the risk is the reality of it) Now they are pressured NoT to treat pain b/c the “Crisis” that started in drug mills and heroin/fentanyl smuggling rings out of Mexico (which the govt also has money involved in but would NEVER admit, and also supply them their guns) SO the ones that end up suffering are the ones in chronic pain. Not to mention eveybodys pain is different. Fibromyalgia can be cured, I had it 10 yrs ago, with good nutrition, clean protein, very low sugar, juicing, can have remarkable effects on the inflammation. ITs slow going, but it took a while to get there too. Sometimes we have to look at the cause and treat that along with making ourselves more comfortable during the long process of getting better. Another weapon in your tool chest could be topicals as in homemade salve, very easy to make (pintrist) (cannabis+ arnica is a great combo w/ shea butter and beeswax, not too expensive to buy all the ingreds) and again, you can try making RSO (Rick Simpson Oil) but it is VERY strong so be careful if you do (also easy to make w/ rice cooker) You will need to become your own physician to get over this, and I wish you all the best. It takes allot of motivation to stay positive, focused and on track. Good luck and happy thoughts to you on your journey to find relief.

  • Darius A Stokes

    It can be better if you put the medicine in the oil while you germinate to mix it in the seed.
    You can also use thin oil closest to the viscosity of water and add flavoring contracting.
    Remember the more flavor extract you use and add to oil the more it holds.
    In a single drop of oil you can place i believe 10 drops per 10 min each seed and it will germinate
    with the flavor the extract have water in it

  • Douglas Wing

    i’ve been taking 2 drops of Rick Simpson Oil a day since 2011, after taking 20 drops a day for 60 days to cure the lung cancer that had spread following 24 radiation treatments. all this time i’ve been virtually pain free ….. no head aches, arthritis, no need for aspirin, bufferin, excedrin etc.,and i havent had a cold or sore throat. obviously this 83 year old is a believer in this god given medicine.

    • Micah Rowen

      Did it kill your lung cancer?

  • Reducing the number of opioid prescriptions is a crucial step in addressing the crisis. And cannabis could make it happen. If you reside in CA and are suffering from chronic pain, visit

  • Hazel Andersen

    Totally helped with my Peripheral neuropathy, and a lot of other issues I have from a botched Laparoscopic Gallbladder operation, leaving me with a severe brain injury…lots of “meds” but all have major issues and interactions. Decided to talk to my Dr. about a year and a half ago. He was very helpful and gave me a RX for MMJ. I now have hours free of pain, I lost 65lbs and have way more energy!! Gabapentin, was the major assault on my body and brain. I live in Victoria, BC Canada, and find most professionals I see are quite interested in how well I am doing.

  • Futureworld X Jones

    I have extreme pain from surgery, after surgery due to Colon Cancer, and I’ve been smoking regular Kush, and sour diesel for years , but all it really does is help me deal better emotionally with the pain. I still feel a hot, pulsing burn in my entire pelvic region, and my rectum. When I was in Alaska, I tried the oil, and it was…. (I struggle to find words) amazing.(still not good enough). I just fear that it may make me sleep like the opioids I take now, and that is the main reason why I cannot understand how people can be addicted to walking around like a freakin’ ZOMBIE!!! I need to know if I can do it without an opioid back-up.

  • Rick Risner

    I used marijuana to get off 5 years of prescribed opiates and when you use marijuana and happen to run low, you don’t have the terrible withdraws that you do with Hydros, oxycotins, methadone , just to name a few,, cannabis legalization is way overdue

  • Donna

    Does this show up in your blood or urine ?

  • William

    Pure opioids are not toxic; typically, it is when they are combined with such other substances as acetaminophen that they become potentially toxic. Opioids are sourced from another plant, Papaver somniferum, and ancient medicine. Cannabis and somniferum are probably the oldest known, most widely used medicines. Yes, opioids are very serious. Smoking anything is not good for you. Make tea. Opium is widely agreed to be the substance Jesus was given on the cross, its key ingredient morphine. As a severe chronic pain patient, and opioid patient for nearly 20 years, I understand the demonization of opioids. Purdue Pharma screwed the pooch, and now the demonizing of opioid is quite a bit like marijuana was demonized for years. Used properly, the poppy plant is unsurpassed for pain control of many kinds. And, yes, cannabis is a great plant.

  • Zoey Thompson

    Look no more. Check out AnnCannMed for your health prescriptions and medical purchases and feel support talking to licensed physicians.

    • Brian Woodworth

      I’ve just bought cannabis oil from them. The salesperson was nice and the order process is simple.

    • I have been suffering from severe back pains and anxiety for 6 years now, i have tried all types of pain relief pills to no avail. A friend of mine did some research about cannabis online and directed me to this firm which i did. Today am happy and to say am now pain free.

    • Bryan Rowley

      Extremely helpful company, nothing is too much trouble. Your cannabis pills have made a considerable difference to my sister’s health.

  • Designer_Dude

    The last paragraph state “What we’ve found is that these strains can be highly effective in low to moderate doses”. It’s vague what “these strains” it’s referring to. Is it talking about the indica or sativa strains, which were both mentioned in the prior sentence?

  • Kevin Ameling

    Update, 1 year later doing great, my daily “medicine” is now a 1:1 ratio tincture of THC:CBD for even better results.
    Seek out quality companies in your area and try different cannabinoids and ratios.

  • Smith Hoover

    How to sensibly buy LEGAL cbd oil? Because I got a letter saying customs has confiscated my package two times already and I’m pissed.

  • Mikhaila Weber

    Reducing the number of opioid prescriptions is a crucial step in addressing the crisis. And cannabis could make it happen. If you reside in CA and are suffering from chronic pain, I’d recommend 420 doctors at OnllineMedicalCard

  • Ron

    Should check out the The *Chronic* Pain Cane. at it’s very cool

  • Michelle Benavidez

    I would love for marijuana to be used for chronic pain, but you gotta drop the price its too expensive when pills are cheaper than a gram of flower I pay 10 dollars a month for my pain pills. I can only get a gram which would last me half a day. The government wants you addicted to these pills

  • Johnson
    • Sandra

      Sports injuries and car accidents have meant years of chronic pain, chiropractors, acupuncturists, and physical therapy, which have all not helped. But only CANNAPHARMAS 50/50 Oil provides total pain relief and restores complete range of motion.

  • kracker

    I was given only a month to try Medical Marijuana and could not find a dose or strain that controlled my pain like my opioids did. I actually had an increase in my pain in this time and my am now back to the opiates but half the dose I use to take. I am only given 30mg a day which is putting me through hell because I am not allowed to continue the medical Marijuana. My opiates are way to low and my nerves are shot. Why can’t the government leave us responsible patients alone