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Is Cannabis an Effective Painkiller After Major Surgery?

How effective is cannabis at relieving post-surgery pain? And how does it stack up against opioids and other pain medications in terms of effectiveness, accessibility, and side effects? Read on to learn more.

These days, cannabis has many applications. Apart from its usual recreational purposes, the magic herb has been credited anecdotally and scientifically for its potential health and wellness-promoting attributes. Just by looking at published research over the last few decades, you’ll find a lot of literature on it.

For this article, we’ll talk about how cannabis could be effective for pain relief after major surgery. Is it a better alternative to over-the-counter medication? Or are we better off with opioids and other pharmaceutical drugs?

Contents:

We’ll delve into this topic by going through what the scientific research says, as well as the other options people opt for. If you’re considering CBD or THC to alleviate your post-op pain, this piece should begin to answer your questions.

Current Treatments for Post-Surgery Pain

Not all surgeries are a smooth process. Some procedures are a bit rough, but you end up doing fine afterward; other surgeries will leave you aching like you just went through a six-round boxing match.

Before cannabis legalization, and still today, doctors were inclined to prescribe more traditional options for pain relief; some of them drug-induced, others not.

The type of treatment one undergoes depends on the type of surgery, as well as one’s pain tolerance. Most of these forms of treatment are generally safe, save from some side effects like nausea, drowsiness, and vomiting.

Local Anesthetics

Anesthetics numb a particular portion of the body for a short period of time. Some of them can be taken orally, while others come in the form of a topical medication.

In some cases, nerve blocks are offered to patients who find their pain to be unbearable. Similar to most anesthetics, a nerve block desensitises the particular region of the body from which the pain radiates. It is usually administered through a catheter.

What’s great about nerve blocks is that they lessen the amount of opioid medication administered. That means fewer, less intense episodes of nausea, drowsiness, and other side effects.

Local Anesthetics

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

You’ve likely taken some ibuprofen for a really bad toothache or some celecoxib to rid yourself of a migraine.

All of these are nonsteroidal anti-inflammatory drugs (otherwise known as NSAIDs), and, as the name suggests, are used primarily to reduce inflammation. You can purchase them even without a prescription.

The main advantage of taking NSAIDs is that they do not cause any impairment. But there are possible side effects like dizziness and stomach issues to consider. They can also pose a problem for those suffering from stomach ulcers or those taking blood thinners.

Even with the accessibility of NSAIDs, it would still be best to consult a professional before using them.

Current Treatments for Post-Surgery Pain

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Relaxation Techniques

For those who aren’t a fan of loading their bodies with drugs, there are relaxation techniques to help alleviate post-surgery pain.

One good example is guided imagery, wherein you draw up a calm, soothing image in your mind. The purpose of this technique is to provide you with a pleasant distraction from the pain, therefore reducing its intensity.

Homeopathic remedies like cold or heat therapy also work to reduce the swelling and make the pain more manageable. As for which one to go with, it will depend on the advice of your doctor or practitioner.

Relaxation Techniques

Non-Opioid Analgesics

If you’re dealing with mild to moderate pain that you no longer want to feel, analgesics are the way to go. They are often effective on their own and lessen the need to take other medications, thus reducing the potential for side effects.

Like NSAIDs, most analgesics are safe for consumption. You can purchase them from your local drug store without the need for a prescription.

One thing you will have to watch out for, however, is possible liver damage if you go over the prescribed dosage. If you’re already dealing with pre-existing liver problems, you will need to consult a doctor beforehand.

Non-Opioid Analgesics

Opioids for Post-Surgery Pain Relief

Certain opioids are commonly used to relieve post-surgery pain. Those experiencing intense pain are usually prescribed these medications.

Upon taking these drugs, they bind with opioid receptors in the brain and spinal cord. Signals are then sent through the entire body, telling it that it’s not in pain.

The biggest advantage of taking opioids for pain relief is that the effects are immediate. Agony is replaced by a distinct euphoric feeling.

But, like any other synthetic drug, the drawbacks are punishing, especially when abused.

Physical Side Effects of Opioids

The first few tell-tale signs of opioid dependence are the physical side effects. A few people experience drowsiness, while others go through bouts of constipation.

Some may brush them off as a normal occurrence, but experiencing these symptoms first-hand will tell you that something is not right with your body.

Physical Side Effects of Opioids

Tolerance and Withdrawal

The more frequently you take opioids, the easier it is for your body to build a high tolerance to them. So, what do you do? You increase your dosage to unhealthy levels to feel something.

The withdrawal symptoms after you quit aren’t at all fun. They involve muscle pain, nausea and vomiting, and abdominal cramps, just to name a few.

Now you’re in an ugly irony wherein the drugs that are supposed to provide you relief are actually causing you these excruciatingly uncomfortable moments.

Mental and Behavioural Changes

Prolonged opioid use will lead to the body’s dependence on these drugs. The brain stops its production of certain hormones and neurochemicals, and instead relies on the opioids to do the work.

The result? The brain also begins to respond to the environment differently. Certain cues and triggers may remind the person about the drug, which ultimately builds up an unwanted craving.

That dependence also tends to lead to desperate acts just to get the fix. It could be stealing money from family members or other crooked acts.

What Does Research Say About Cannabis for Pain?

Now, let’s get into the meat of the matter. How exactly does science view medical cannabis for post-surgery pain?

As it is with other findings on cannabis, experts have found some positives and some negatives.

Medical Cannabis for Pain Control

In one study conducted in 2008 [1] , researchers found a connection between cannabis and pain control. The link? Our body’s endocannabinoid system.

See, when THC enters the body, it binds with CB1 and CB2 receptors within the ECS. The activation of these receptors has the potential to produce anti-inflammatory effects that relieve pain and reduce hyperalgesia (abnormally heightened pain sensitivity). Those who suffer from fibromyalgia and migraine are all too familiar with it.

That’s not all. THC can also modulate both dopamine and serotonin levels, which could also help in pain reduction.

CBD, a non-psychotropic compound, also displays efficacy as a potential anti-inflammatory [2] compound through its indirect action on the ECS. The full scope of CBD’s analgesic potential is up for debate, but it hints at the possible effectiveness of full-spectrum cannabis therapeutics.

Medical Cannabis for Pain Control

Medical Cannabis to Lower Painkiller Use?

The opioids themselves aren’t the only issue. Another major issue is the accessibility to such drugs, and the ease with which they can be misused and abused.

However, recent studies [3] show how medical cannabis could potentially lower the likelihood of opioid use. One study observed that 82% of 1,000 respondents taking cannabis to manage pain were able to either reduce or completely stop taking over-the-counter pain medication. Another 88% were able to quit opioid painkillers completely.

In some cases, people resort to medical cannabis to avoid the unpleasant side effects brought on by certain medications. But, ultimately, controlled use of marijuana for therapeutic purposes allows patients to experience relief without opioids. Therefore, the chances of developing a tolerance and dependence are significantly lessened.

Medical Cannabis as a Possible Gateway to Opioid Use

On the flip side, the negatives of medical cannabis use also need to be taken into account. As this 2016 retroactive pilot study [4] shows, chronic marijuana consumption may lead to eventual opioid use.

The study involved motor vehicle crash patients in Colorado and Texas hospitals, and ultimately concluded that chronic cannabis use possibly affects the pain response by requiring higher doses of analgesic opioids to achieve relief.

However, it is worth noting that these findings were specifically seen in chronic users. Episodic users showed no differences in their desire to use opioids.

Is cannabis an effective painkiller following surgery? And, if so, how does it compare to traditional medications like opioids? Find out more inside.

Does CBD oil work for chronic pain management?

Many people use cannabidiol (CBD) to relieve pain. Understanding CBD can help overcome the stigma associated with it.

CBD oil is derived from the cannabis plant. People report using this oil for relief from pain, anxiety, depression, and sleep disorders.

There is limited evidence from human studies to support the benefits of CBD oil, due to restrictions on the use of and research on cannabis. As cannabis is becoming legalized in various regions, research is gaining momentum and shows some promising results.

In this article, we look at how CBD oil works and how people use it to relieve chronic pain.

A small bottle of CBD oil against a green background with a dropper held above it

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CBD is one of more than 100 compounds found in cannabis, called cannabinoids. Many plants contain cannabinoids, but people most commonly link these compounds to cannabis.

Unlike other cannabinoids — such as tetrahydrocannabinol (THC) — CBD does not produce a euphoric “high.” This is because CBD does not affect the same receptors as THC.

The human body has an endocannabinoid system (ECS) that receives and translates signals from cannabinoids. It produces some cannabinoids of its own, which are called endocannabinoids. The ECS helps regulate functions such as sleep, immune-system responses, and pain.

When THC enters the body, it produces a “high” feeling by affecting the brain’s endocannabinoid receptors. This activates the brain’s reward system, producing pleasure chemicals such as dopamine.

Does CBD make you high?

CBD is an entirely different compound from THC, and its effects are very complex. It does not produce a “high” and does not impair a person’s functioning, but it influences the body to use its own endocannabinoids more effectively.

According to a 2015 study published in Neurotherapeutics, CBD influences many other receptor systems in our body and will influence the ECS in combination with other cannabinoids.

For example, CBD can increase the body’s levels of anandamide, a compound associated with regulating pain, which can reduce pain perception and improve mood.

Cannabidiol may also limit inflammation in the brain and nervous system, which may benefit people experiencing pain, insomnia, and certain immune system responses.

For more information and resources on CBD and CBD products, please visit our dedicated hub.

Different varieties of cannabis plants — such as hemp and marijuana — contain different levels of chemical compounds.

How people breed the plant affects the CBD levels. Most CBD oil comes from industrial hemp, which usually has a higher CBD content than marijuana.

Makers of CBD oil use different methods to extract the compound. The extract is then added to a carrier oil and called CBD oil.

CBD oil comes in many different strengths, and people use it in various ways. It is best to discuss CBD oil with a doctor before using it.

According to the National Centers for Complementary and Integrative Health (NCCIH), some evidence suggests that cannabis or CBD could have modest benefits for chronic pain.

While CBD is a promising option for pain relief, research has not yet proven it safe and effective, and the Food and Drug Administration (FDA) have not approved CBD for treating pain.

A 2020 review reports that CBD could have benefits for relieving chronic pain, improving sleep, and reducing inflammation, but that these effects are condition-specific.

More evidence is needed to determine the therapeutic potential of CBD and to determine safe and effective dosages for pain.

Based on the current research, here are some possible benefits of CBD oil:

Neuropathic pain

Neuropathic pain is pain caused by damage to the nerves. This type of pain is common in diseases such as multiple sclerosis, injuries such as herniated discs, and infections such as shingles.

A 2017 review found that CBD helped with chronic neuropathy pain in humans. The researchers looked at 11 randomized controlled trials with 1,219 patients.

However, a 2018 Cochrane review concluded that the potential benefits of cannabis-based medicine might be outweighed by its potential harms.

This research looked into the effects of cannabis-derived medicines, including CBD, for chronic neuropathic pain. It looked at 16 studies and 1,750 participants.

More research is needed to understand the role of CBD in chronic neuropathic pain management, including the risks, benefits, and ideal dosages.

Arthritis pain

A 2016 study in the European Journal of Pain used an animal model to see if CBD could help people with arthritis manage their pain. Researchers applied a topical gel containing CBD to rats with arthritis for 4 days.

Their researchers noted a significant drop in inflammation and signs of pain, without additional side effects.

People using CBD oil for arthritis may find relief from their pain, but more human studies need to be done to confirm these findings.

Multiple sclerosis

Multiple sclerosis (MS) is an autoimmune condition that affects the entire body through the nerves and brain.

Muscle spasms are one of the most common symptoms of MS. These spasms can be so strong they cause constant pain in some people.

One report found that short-term use of CBD oil could reduce the levels of muscle spasms a person feels. The results are modest, but many people reported a reduction in symptoms. More studies on humans are needed to verify these results.

Chronic pain

The same report studied CBD use for general chronic pain. Researchers compiled the results of multiple systematic reviews covering dozens of trials and studies. Their research concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults.

A separate study in the Journal of Experimental Medicine supports these results. This research suggests that using CBD can reduce pain and inflammation.

The researchers also found that subjects were not likely to build up a tolerance to the effects of CBD, so they would not need to increase their dose over time.

They noted that cannabinoids, such as CBD, could offer helpful new treatments for people with chronic pain.

CBD currently has a range of applications and promising possibilities.

  • helping people quit smoking
  • managing drug withdrawal
  • treating seizures and epilepsy
  • treating anxiety
  • reducing some effects of Alzheimer’s disease
  • reducing antipsychotic effects for people with schizophrenia
  • potentially combating type 1 diabetes and cancer in the future

Although more research is required to confirm the benefits of CBD oil, it is shaping up as a potentially promising and versatile treatment.

The Food and Drug Administration (FDA) have approved one form of CBD, called Epidiolex, to treat two rare forms of epilepsy and to treat seizures caused by a rare condition called tuberous sclerosis complex.

More generally, marijuana-derived CBD products are not yet legal at the federal level but are legal under the laws of some states.

People should check their state’s laws and those of any place they intend to travel. They must keep in mind that the FDA do not approve or regulate nonprescription CBD products. As a result, labeling may be inaccurate.

The FDA does not regulate CBD for most conditions. As a result, dosages are currently open to interpretation, and people should treat them with caution.

Anyone who wishes to use CBD should first speak to a doctor about whether it will be beneficial or safe, and how much to take.

The FDA has approved a purified form of CBD for some types of epilepsy, with the brand name Epidiolex. People using this medication should follow the doctor’s advice about doses.

Most people tolerate CBD oil well, but there are some possible side effects.

According to a 2017 review in Cannabis and Cannabinoid Research, the most common side effects include:

  • fatigue
  • diarrhea
  • changes in appetite
  • weight gain or weight loss

In addition, using CBD oil with other medications may make those medications more or less effective.

The review also notes that scientists have yet to study some aspects of CBD, such as its long-term effects on hormones. Further long-term studies will be helpful in determining any side effects CBD has on the body over time.

Consult a doctor before using CBD, as it may interact with certain over-the-counter dietary supplements and medicines, as well as some prescription medications — especially those that warn against consuming grapefruit .

CBD might also interfere with an enzyme called cytochrome P450 complex. This disruption could affect the liver’s ability to break down toxins, increasing the risk of liver toxicity.

The patient information leaflet for Epidiolex cautions that there is a risk of liver damage, lethargy, and possibly depression and thoughts of suicide, but these potential side effects are true of other treatments for epilepsy, too.

One study in Frontiers in Pharmacology, suggested cannabinoids’ anti-inflammatory effect may reduce inflammation too much. A large reduction in inflammation could diminish the lungs’ defense system, increasing the risk of infection.

Almost all research on CBD oil and pain comes from adult trials. Experts do not recommend CBD oil for use in children, as there is little research on the effects of CBD oil on a child’s developing brain.

However, people may use Epidiolex for children ages 2 and above who have rare forms of epilepsy.

People should not use CBD oil when pregnant or breastfeeding.

People should use caution when taking CBD products by mouth alongside high-fat meals. High-fat meals can dramatically increase the blood concentrations of CBD, which can increase the risk of side effects.

The FDA does not regulate CBD products in the same way they regulate drugs or dietary supplements, so companies sometimes mislabel or misrepresent their products. That means it’s especially important to do some research and find a quality product.

While many studies have suggested CBD oil is helpful for pain, more research is necessary, especially long-term studies with human subjects.

However, CBD oil does show promise as a treatment for pain. Some scientific and anecdotal evidence suggests that it can help people manage chronic pain in various contexts.

CBD oil is especially promising due to its lack of intoxicating effects and a possible lower potential for side effects than many other pain medications.

People should discuss CBD oil with their doctor if they are considering using it for the first time.

What precautions would you advise if someone wants to try CBD oil to treat pain?

Users should follow legal channels to obtain CBD.

The science is emerging to support its use, especially in a time where most people want to avoid addicting opioids while treating chronic pain.

Because of the changes in social acceptance for the use of the marijuana plant and the urgency to address the opioid crisis, there is funding for clinical trials.

A 2017 study found CBD was effective for chronic neuropathy pain. It may have a role in reducing inflammation as well.

An individual should talk to a doctor first, start with the lowest doses possible, read the information available, and be an informed consumer.

Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Is CBD legal? Hemp-derived CBD products with less than 0.3% THC are legal federally but still illegal under some state laws. Cannabis-derived CBD products, on the other hand, are illegal federally but legal under some state laws. Check local legislation, especially when traveling. Also, keep in mind that the Food and Drug Administration (FDA) have not approved nonprescription CBD products, which may be inaccurately labeled.

Last medically reviewed on November 3, 2020

Cannabidiol or CBD oil has become popular for pain treatment. This article looks at how it works, how to use it, and the benefits and risks of CBD oil.