Researchers want to know how many patients are trading in pharmaceuticals for medical cannabis.

Another cannabis chronic pain study is underway at the University of Georgia, funded by a $3.5 million grant from the National Institute on Drug Abuse, a subsidiary of the National Institutes of Health.

Researchers will analyze data from states legal for medical cannabis. The intent is to find out if pain patients are reducing consumption of pharmaceutical in favor of medical cannabis.

“We are thrilled to get started on this work,” said Grace Bagwell Adams, assistant professor in the College of Public Health. “Much of the policy change has happened quickly in a landscape that is not well understood at the patient level. This work is going to contribute to our understanding about the intersectionality of medical cannabis policy and the behavior of chronic pain patients.”

Do Medicine Choices Change in States that Legalize?

The study will use information from the Research Data Assistance Center (U of Minnesota). Further insight will be obtained from the Health Care Cost Institute database. It will also gather data from Medicare, Medicaid, and privately insured individuals. Pain management decisions of medical cannabis patients is the subject of the study.

“Researchers have been able to document reductions in aggregate prescription use, especially opioids, after states implement MCLs [medical cannabis laws], but there is almost no research on how a large representative sample of individual patients respond to medical cannabis access. Do we see lots of patients reducing opioid use, or just a few patients reducing by a lot? What happens to other kinds of health care use, like emergency room visits or physician office visits? We don’t know, and we’re excited to find out,” said David Bradford, George D. Busbee Chair in Public Policy in UGA’s School of Public and International Affairs.

What About Other Chronic Pain Studies?

Last February, an analysis of 15 states in the journal Health Affairs study showed that chronic pain is the most common reason given by patients have opted for legalized medical cannabis treatment. It’s a trend that’s growing, as shown in an earlier study in 2014 that associated medical cannabis legalization with lower rates of state-level opioid overdose. And in 2017, a clinical review in Cannabis and Cannabinoid Research discovered that along with helping to treat chronic pain, cannabis can reduce the number of opioids needed to alleviate that pain.

Other countries, where cannabis has been legalized, have followed suit with similar chronic pain studies. In 2017, Canadian researchers published a report in the International Journal of Drug Policy that found more than half of 271 medical cannabis patients had dropped their usage of pharmaceutical drugs to treat pain.

In Europe, findings published in March 2018 in the European Journal of Internal Medicine showed that among 2,735 patients over the age of 65, about 67 percent of survey respondents said they chose medical cannabis for pain relief.

In Theory: How Cannabis May Treat Pain

Cannabis for chronic pain can vary greatly, depending on the person and their condition. Different from opioids, cannabis changes the perception of pain instead of completely eliminating it. This is what makes opioids so addictive. However, the right type of cannabis medicine for treatment is dependent on what kind of pain you’re in.

Anecdotally, pain that results from inflammation tends to respond better to CBD-rich chemovars. This is believed to be because of the effect of cannabis on receptors such as GPR55 and TPRV1. CBD doesn’t appear to be as effective in treating pain that stems from non-inflammatory factors.

Some patients do report that cannabis helps non-inflammatory pain. Nerve pain can potentially be alleviated with THC, because it strongly activates the CB1 receptor, which impacts the glutamatergic system — a neurological pathway the body.

Choosing the Right Kind of Cannabis for You

As researchers study cannabis’ chronic pain relieving properties, this much is clear, a wide-range of factors must be considered. Some of these considerations include legal access, the type of pain, and comfort-level with cannabis. Experimentation may also be necessary to find what works. You might find that you prefer a combination of tactics for your condition.

Everyone is different, which is why it’s important to read about the varied properties of cannabis medicine, and how they fit into your daily routine when deciding on a course of treatment, as well as consulting your medical cannabis doctor for a more personalized recommendation.