BY KASANDRA BRABAW
As of 2019, 33 U.S. states and Washington, D.C. have legalized medical marijuana, thus recognizing the plant’s potential to help people who are sick or experiencing pain. But in some cases, cannabis might not just be an additional option for treatment: It could be the safer alternative.
That’s especially true in comparison to opioid painkillers like OxyContin and Vicodin. As the country continues to grapple with a nationwide opioid epidemic, many medical doctors have become increasingly wary about prescribing the powerful drugs. “Opioids can be very dangerous. They’re physically and chemically addicting,” says Oliver Park, MD,a cannabis-friendly doctor in New York. “We’re in the midst of an unprecedented opioid crisis; a lot of people are dying.”
There’s no doubt that cannabis is safer as an alternative to highly addictive painkillers, Dr. Park says. Prescribing cannabis is one part of a multifaceted effort by government officials, medical doctors, and public policy advocates to address the opioid crisis, he says. Granted, cannabis likely won’t be replacing over-the-counter options anytime soon—common anti-inflammatory drugs like ibuprofen and acetaminophen, which treat everyday maladies like headaches and fevers, aren’t concerning enough to need an alternative. Opioids, meanwhile, are prescribed for people who have chronic pain, or who are recovering from a serious injury or surgery, Dr. Park says. You might be able to get a cannabis prescription for chronic migraines, for example, but not necessarily for the occasional headache.
And yet, chronic pain wasn’t accepted as a qualifying condition for medical marijuana in New York until March 2017. Now, Dr. Park says that almost all of the 33 states that have legalized medical marijuana accept pain as a reason to prescribe cannabis. In New York, that means anyone experiencing frequent pain for three or more months—pain that causes them to lose focus at work or otherwise disrupts their lives—can go to a doctor and get a prescription for cannabis. “I would say the majority of my patients are having chronic pain issues,” Dr. Park says. “That is for sure the most common reason to get qualified.”
Since the medical program is still relatively new in many states, Dr. Park says that not every general care practitioner knows how to prescribe the plant. So, your regular doctor might refer you to a marijuana-friendly doctor like him. In the year and a half that he’s been suggesting patients use cannabis, Dr. Park has learned how to guide them toward the best types and dosages.
Some dispensaries carry specific strains of the plant, he says. But in New York, for example, medical marijuana dispensaries (including MedMen) don’t carry smokable cannabis, because smokingmarijuana is still illegal in the state. Instead, New York dispensaries offer patients tinctures, vapes, and pills, and since each format is derived from cannabis plants’ extracts, the dispensaries have a lot of control over how much THC and CBD are in each dose. (Note that regulations for medicinal usage varies state by state.)
Generally, Dr. Park says there are three types of dosing: High THC and low CBD, equal amounts of both THC and CBD, and low THC with high CBD. Dr. Park might suggest a patient use different dosages or combinations at different times of the day. Someone who has to focus at work, for example, would get the most out of a high CBD and low THC mix during the day, that way they can function at work with minimal psychoactive effects from the THC, but will still experience cannabis’ healing benefits thanks to the CBD.
No matter what, the combination of THC and CBD can more effectively treat pain than either compound alone, Dr. Park says. “THC masks the pain and CBD is anti-inflammatory, so it treats pain at the site,” he says. While there may be many totally legal, prescription-free CBD options for sale now, and they might even help in some cases, chronic pain will always be better treated with a combination of THC and CBD.
So, if you’re considering cannabis to treat pain, the first step is to see a doctor who has experience working with cannabis, and who will be able to help you figure out how to best approach to treating your pain. “Marijuana use is a very personal thing,” Dr. Park says. “It takes a bit of time to find a regimen that works.” Talk to your doctor and talk to the pros at your local MedMen, and before you know it, you will have a starting point for managing pain with cannabis.