Neuropharmacology Expert Explains How Cannabis Can Treat Pain
A researcher in neuropharmacology studied opioids and cannabinoids in the treatment of pain and addiction. His research focuses on developing drug compounds that can relieve chronic pain without the risk of overuse and the diminished efficacy that often accompanies traditional pain relievers.
How opioids work
Our body has its own built-in opioid system that can help manage pain. These opioids, like endorphins, are chemicals that are released when the body experiences stress, such as intense exercise, as well as in response to pleasurable activities such as a good meal. But it turns out that humans aren't the only organisms capable of making opioids.
In the 1800s, scientists discovered that morphine, an opioid isolated from opium poppy, was very effective in relieving pain. Over the past 150 years, scientists have developed other synthetic opioids like hydrocodone and dihydrocodeine that also provide pain relief.
Other opioids like heroin and oxycodone are very similar to morphine, but with small differences that affect how quickly they work on the brain. the fentanyl has an even more unique chemical composition. It is the most potent opioid and is responsible for the current spike in overdoses and deaths, especially among young people.
Opioids, whether naturally produced or synthetic, relieve pain by binding to specific receptors in the body, which are proteins that act like a lock that can only be opened by an opioid key.
One of these receptors, called mu-opioid receptor, is found on pain-transmitting nerve cells along the spinal cord. When activated, mu receptors reduce the cell's ability to relay pain information. So when these opioids travel through the body and reach their receptor, the stimuli that would normally cause pain are not transmitted to the brain.
These same receptors are also found in the brain. When opioids find their receptor, the brain releases dopamine, the so-called “feel-good” chemical, which has its own receptors. This is, in part, why opioids can be highly addictive. Research suggests that these receptors fuel the brain's reward system and promote drug seeking. For people who are prescribed opiates, this creates a risk of abuse.
Opioid receptors are dynamically regulated, which means that when exposed to more and more opioids, the body quickly adapts by turning off the receptor. In other words, the body needs more and more of this opioid to relieve pain and produce a feeling of well-being. This process is known as tolerance. The drive to seek ever-increasing reward, coupled with ever-increasing tolerance, is at the root of the risk of overdose. This is why opioids are generally not long-term solutions for pain relief.
THC and CBD for the treatment of pain
However, it is intriguing to note that the research suggests that cannabis use may also reduce the need for opioids directly by interacting with the body's natural opioid system to produce analgesic effects Similar.
Numerous studies have shown that THC and CBD both reduce pain, although, importantly, they differ in the receptors they bind to to produce these effects.
THC binds to cannabinoid receptors that are located throughout the central nervous system, producing a variety of responses. One of these responses is the euphoria associated with cannabis use, and another is pain relief. Additionally, THC is thought to reduce inflammation similarly to anti-inflammatories like ibuprofen.
In contrast, CBD appears to bind to several distinct receptors, and several of these receptors may play a role in reducing pain. It is important to note that this occurs without the euphoric effect of THC.
Because they target different receptors, THC and CBD may be more effective when they work together rather than alone, but further studies in animal models and humans are needed.
Cannabinoids can also be useful in other cases. Numerous studies have shown that cannabinoid drugs approved for medical use are effective against pain and other symptoms such as spasticity, nausea and loss of appetite.
Advancing pain research
Along with the combination of THC and CBD, researchers are beginning to explore the use of these two cannabinoids with existing opioids for the treatment of pain. This research is conducted in both animal models and humans.
These studies are designed to understand both the benefits, pain relief, and the risks, primarily the dependency potential, co-treatment with cannabinoids and opioids. The hope would be that THC or CBD could reduce the amount of opioids needed for powerful pain relief without increasing the risk of addiction.
For example, one study tested the combination of smoked cannabis and oxycontin for pain relief and reward. She found that the co-treatment improved pain relief but also increased the pleasure from the drugs. This study, as well as a limited number other studies, suggests that there may be no net benefit.
However, many more such studies will be needed to understand if cannabinoids and opioids can be used together safely for pain. Nevertheless, the use of cannabinoids as a replacement for opioids remains a promising strategy for the treatment of pain.
The next decade of research will likely bring important new insights into the therapeutic potential of cannabinoids in the management of chronic pain. And as the legalization of marijuana continues to spread, its use in medicine will undoubtedly grow exponentially.