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July 20, 2019
Here’s How Cannabis Can (& Can't) Be Used Before A Painful Procedure

BY KASANDRA BRABAW

When it comes to medicine, there’s still a lot we don’t know about cannabis. But one thing we doknow is that the plant is incredibly helpful for people who have chronic pain. Cannabis has been approved to treat a slew of different medical conditions in states that allow medical marijuana, including many medical conditions that involve chronic pain like Multiple Sclerosis and Crohn’s disease.

And if cannabis can help people keep their chronic pain at bay, then it stands to reason that it can help with one-off pains, too, right? Like a pharmacological painkiller, which dulls the pain signals your nerves send to your brain, you’d expect to be able to ingest a little marijuana before heading into a particularly painful ordeal—if you were getting a tattoo, for example, or having an IUD placed inside your uterus—and let it work its pain-reducing magic. Suddenly, the prick of those tattoo needles wouldn’t feel so intense, and those IUD cramps wouldn’t be so painful.

While it’d be great to say it works that way, the truth is that we just don’t know. There isn’t enough science to say that marijuana works to proactively dull pain, says Melanie Bone, MD, an expert in both cannabis and reproductive health. And what little evidence we do have isn’t promising. “A lot of chronic pain is arthritic and due to inflammation,” she says. “Cannabis seems to improve the inflammation and neuropathic signaling.” So while it may seem that all pain is the same, that’s not true—and it means that cannabis isn’t going to be a great solution to all kinds of pain.

The types of pain that we generally want to protect against proactively likely won’t be affected by cannabis, because they’re not caused by chronic inflammation. Plus, there’s a chance that getting high beforehand could make the pain worse. “Most of [the studies we have] are small and flawed, but there is a trend toward showing mild analgesic [painkilling] effects at lower doses and actually a worsening of acute pain when given in higher doses,” Dr. Bone says.

That’s actually (potentially) good news: It means that there’s a tiny chance that taking small doses of cannabis before you head into a painful situation—getting a piercing, going in for a root canal, having a minor medical procedure done—could help. But again, there’s no solid science to say this is definitely true, and neither Dr. Bone nor Jordan Tishler, MD, CEO of InhaleMD, would bet on it.

In fact, attempting to use marijuana in this way brings up some safety issues, Dr. Tisler says. “If it were to work, I’d expect you should use it so that it’s working (i.e. intoxicating) prior to the experience,” he says. “This, of course, brings up some safety concerns, like how are you getting and returning from this experience?” It’d be especially dangerous to try cannabis in a stressful or painful situation if you’re not used to how marijuana reacts with your body, he says. So, if you were to try using cannabis as a pre-painkiller, it’d be best that you know what you’re doing, and that you take only small doses. “Most of my patients experience effects, on average, with 10 milligrams,” Dr. Tishler says. “However, they don’t start on 10 milligrams; they start lower and we work up to the benefits.”

If you’re a cannabis newbie, it’s best to avoid using it when you know you’ll be in some pain. But, if you’re curious about the possibility that marijuana could dull your senses, Dr. Bone doesn’t think it’d hurt (again, if you’re aware of what the plant will do to your body and are taking only a small dose). In fact, she theorizes that the CBD component of the plant could be especially helpful. “Many times, painful situations are especially fraught because they’re also stressful,” she says. CBD has a tendency to help people calm down, and if you feel more calm, you may also feel less pain.

But this is, of course, just a theory. Dr. Bone says much more research needs to be done on the topic before she or any other doctor could suggest that people use cannabis to proactively dull pain. “It’s also worth noting that pain is not inherently bad,” Dr. Tisler says. “It serves a purpose,  which is to make you stop doing something and take notice. Cannabis should not be used to treat pain unless the cause of the pain is well understood, that way we don’t miss something important.”

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