Using Cannabis for Pain Relief - GoodRx (2024)

Humans have used cannabis to help ease pain for at least 5,000 years. Ancient societies in China and India commonly used cannabis for pain relief. It was even sold in American pharmacies until the early 1900s. But modern cannabis is much different than it was hundreds of years ago. And we now have much more scientific research to help us understand its effects on chronic pain.

But cannabis doesn’t work like most other medications — there isn’t a set dosage that works for everyone, and it’s not legal in every U.S. state. And since it’s not an FDA-approved treatment, it can be hard to know where to start if you’re considering cannabis to help manage your chronic pain symptoms.

That’s where this guide comes in. We’ll help you understand how cannabis works for chronic pain and the best steps to take if you’re considering trying it for your symptoms.

How does cannabis help treat chronic pain?

The cannabis plant contains active chemicals called cannabinoids. The two most common cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD), but there are also many more. Cannabinoids interact with the endocannabinoid system and other binding sites in the body to turn nerve signals on or off.

When it comes to cannabis for chronic pain, certain cannabinoids (such as THC) activate receptors in the brain and nerves that help regulate pain. They also activate receptors on immune system cells that help control inflammation (swelling) and the immune system’s response.

Because of these effects, cannabis is being studied as a possible treatment option for several types of chronic pain, including nerve pain (neuropathy), arthritis, and fibromyalgia. It’s also being studied as a possible treatment for pain and swelling related to autoimmune diseases.

Keep in mind: Cannabis is not an FDA-approved medication. In fact, it’s still considered an illegal substance by the U.S. government. Many individual states have passed laws that legalize cannabis for medical use, but there aren’t universal guidelines in place to make sure it’s produced safely. So it’s best to talk to your healthcare provider first about the options in your state and the risks and benefits of cannabis use to protect your health and safety.

What does the research say about using cannabis for pain?

Chronic pain is one of the most common reasons people report using medical cannabis. But the research on cannabis for chronic pain is mixed.

A large number of scientific studies, including randomized controlled trials (the gold standard in medical research), have shown that cannabis is an effective pain reliever for adults with many types of chronic pain. And in a survey of over 900 people with chronic pain, 75% reported pain relief as the main benefit of their cannabis use.

Another study showed that opioid use for pain went down by over 60% in those using cannabis for chronic pain. More research is being done on cannabis as a safer alternative to opioids.

Studies also show that cannabis can improve quality of life and daily functioning for those with chronic pain. This suggests that cannabis may be a good tool for coping with pain, rather than erasing it. Some researchers have referred to this as the “Restored Self” — when cannabis use can help you regain a sense of self and control over your life that chronic pain can take away.

On the other side, several studies have shown that cannabis may increase pain levels for some people. Others show cannabis had no effect on pain levels, although it did improve quality of life measures. There’s also some evidence that cannabis helps pain only because people expect it to, which is called a placebo effect. Finally, many of the studies that show a positive effect of cannabis on pain only include a small number of people, which makes the results less reliable.

What is the recommended cannabis dose for pain relief?

There isn’t a one-size-fits-all cannabis dosage for chronic pain. There are several reasons for this:

• Cannabis isn’t an FDA-approved medication. So there isn’t a standard dosing guideline that’s been proved safe and effective.

• Cannabis is a plant that comes in many different varieties. This makes it hard to replicate from batch to batch. And the different amounts of cannabinoids in each variety will provide different effects.

• Everyone’s endocannabinoid system is different. So your body chemistry may not react to a dose of cannabis the same way as someone else’s.

• Clinical studies don’t translate to the real world. Often, clinical studies use doses or formulations of cannabis that are different from what’s available to people in dispensaries. Or they don’t include detailed dosing information at all.

However, in 2021 a group of twenty experts across nine different countries came together to develop a dosing guideline for cannabis to treat chronic pain. This guideline suggests providers start by giving 5 mg of a high-CBD formulation (no more than 1:10 THC to CBD ratio) by mouth twice a day. If needed, the provider can then increase the dose by 10 mg of CBD per day every 2 to 3 days. Once the dose is up to 40 mg of CBD per day, if the symptoms don’t improve the provider can then start slowly adding on THC, starting with 2.5 mg. More than 40 mg of THC per day isn’t recommended.

This guideline starts with a high-CBD formulation because CBD isn’t intoxicating and has fewer side effects than THC. An oral formulation of cannabis is also preferred, as it lasts longer, has more predictable effects, and less potential for lung damage than inhaled cannabis.

That being said, since inhaled cannabis works faster than other dosage forms, it may be helpful for breakthrough pain symptoms that need faster relief. So experts recommend vaporizing dried flower with a balanced amount of CBD and THC, or a high-THC formulation as needed for breakthrough pain, along with the oral dosing schedule described above.

Keep in mind: Cannabis isn’t an appropriate treatment option for everyone. And this is a general guideline, not an FDA-approved dosing recommendation. So it’s best to talk with your healthcare provider before trying this protocol. They can help make sure it’s safe for you based on your medical history.

What are the possible risks and side effects of using cannabis for pain?

Cannabis use is not entirely risk-free. Like any other substance, there are risks, side effects, and drug interactions to consider.

Most cannabis side effects are related to THC. They include:

• Increased appetite

• Red eyes

• A “high” or intoxicated feeling

• Dizziness

• Drowsiness

• Slowed sense of time

• Racing heart

• Diarrhea (CBD-related)

These side effects can often be avoided by following a dosing schedule that slowly increases your dose over time, such as the one described above. If these effects occur, they’re usually simple to manage on your own and will go away as the cannabis dose wears off.

There are also more serious risks of cannabis use. They’re mainly related to THC’s effect on your brain. THC can cause the following symptoms, especially with higher doses:

• Feelings of fear or anxiety

• Vomiting that won’t stop (cannabis hyperemesis syndrome)

• Impaired thinking and coordination

• Problems with memory

• Seeing, hearing or feeling things that aren’t real

• Irrational thoughts or feelings that you are not yourself

Cannabis high in THC can also be habit forming. So it might not be a good option for those with a history of substance misuse or dependence.

Successful pain management with cannabis includes using it responsibly and at the lowest effective dose for your symptoms. And high-CBD or balanced CBD to THC products are preferred for pain management to reduce the above risks.

Does cannabis interact with other pain medications?

Possibly. Taking cannabis with certain pain medications can raise your risk of side effects, such as dizziness and drowsiness. But in some cases, cannabis may help other pain medications work better or allow you to take less of them — such as with opioid pain medications.

But combining pain medications isn’t something you should do on your own. Your healthcare provider can help you find the best treatment options for your pain and make any changes to your treatment safely.

If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-HELP (4357) to learn about resources in your area.

DISCLAIMER: Keep in mind that cannabis is legal in some states for recreational and/or medicinal use, but not in others. Cannabis is still illegal under federal law. Before you use cannabis products, find out the laws in your state.