Are you trying to decide between CBD and THC for relieving chronic pain? Deciding between CBD or THC for pain is not an easy process. This is because pain is a complex symptom with a myriad of possible causes—no one treatment works for every kind of pain.
Why use cannabis for pain relief?
With over 100 million Americans suffering from chronic pain, a safe and effective treatment is needed, and this does not exist with the presently available pharmaceutical options.
Medical marijuana is becoming one of the most popular alternative treatments for chronic pain – this can range from pain caused by conditions such as migraines or arthritis to pain caused by injury.
The earliest evidence of its medicinal use dates back to 2700 BC when Chinese Emperor Shen Nung documented the analgesic (pain-relieving) properties. Shen Nung is considered by many to be the father of Chinese medicine, which has helped to heal people through the use of natural remedies for thousands of years.
We have now entered a time where the benefits of this plant are beginning to come back to the forefront of the discussion. Indeed, countless individuals across the world have access to legal marijuana for chronic pain conditions.
Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the two most abundant, and also the two best-known compounds. Each of these cannabinoids has different properties and can affect the body in very different ways. But what’s the difference between the two? How do you know which is best for you?
Up until fairly recently, most people associated cannabis with getting high, which meant that the focus was solely on THC. In recent times, however, scientists have discovered CBD and other cannabinoids, meaning that suddenly a new door is open in terms of researching the medicinal benefits of cannabis. However, each strain produces very different amounts of each compound.
Research on the use of either CBD or THC for pain modulation is either limited or inconclusive, partially due to the difficulties in getting federal approval to research cannabis. The design was also problematic in some studies. It’s clear, though, that more robust, well-designed clinical trials and studies are needed before guidelines can be standardized regarding (for instance) indication, product dosage, potency, and formulation.
Both THC and CBD contribute to the positive effects associated with marijuana. However, experts only link THC to the strong psychoactive effect known as getting high. This is one of the primary differences between the two components.
CBD and THC Neuroactivity
THC – When ingested, THC binds primarily with our CB1 receptor sites, as well as our CB2 receptors. Acting as an agonist, it stimulates neurotransmission, encouraging and producing activity.
CBD – Rather than activate your CB1 and CB2 receptors, CBD acts as an antagonist, blocking their processes. For example, Epilepsy is often caused by overactive neuroreceptors, resulting in seizures. When you introduce the right phytocannabinoids, they will take over and interrupt the effect.
Noteworthy Point – THC encourages receptor activity while CBD blocks it. So, if you have taken too much THC and are not enjoying the effect, taking CBD may help to block what’s happening.
Cause and effect on emotions
THC – THC causes the release of chemicals within the reward and pleasure centers of the brain and as a result, it can give a sense of calm and euphoria. Depending on the dose, THC can help the brain produce proper levels of dopamine and serotonin. If you take a little more than you need, your receptors might become overstimulated and get you high.
CBD – Acting as an antagonist, CBD blocks the activity of the receptors that respond to stress. Instead of stimulating calming chemicals, CBD blocks physical fight or flight reactions when stress is occurring. This is why CBD doesn’t produce the same feelings as THC and works more as an anti-anxiety agent; it’s a blocker, not a producer.
Effects of High-THC Strains
THC is the primary psychotropic component in marijuana, that is the component responsible for an altered state of mood and perception. This effect makes THC attractive to recreational users.
But THC also contains strong anti-inflammatory and analgesic properties, so it has shown some success in the treatment of pain caused by inflammation, such as arthritis, and cancer.
THC relaxes the nervous system, which helps in spasm-related pain, such as multiple sclerosis. The altered mental state caused by THC can contribute to relieving severe pain in some cases in the same way medicine uses opiates to treat pain.
Although there is plenty of research supporting the use of cannabis for pain relief in conditions like Crohn’s disease, chronic migraine, and fibromyalgia, less attention has been paid to the specific benefits of THC. The few studies that are available tend to be small and show conflicting results.
A recent study in Neurology found THC is effective for alleviating chronic nerve pain. A larger study, involving 177 cancer patients, found that while THC was not effective at reducing pain, the patients who took a CBD/THC combination had their pain reduce by over 30 percent when compared to placebo. Another double-blind study supported this conclusion when using THC for post-surgery pain. Meanwhile, a 2017 study found both THC and CBD, when taken alone, were effective for reducing chemotherapy-related pain in mice.
Effects of High-CBD Strains
CBD has received recognition for its anti-carcinogenic qualities. Alongside the lack of feeling “high,” CBD has shown positive anti-inflammatory and pain relief effects. Clinical trials have proven links to suppressing pain receptors from some of the chemical reactions caused by CBD.
For example, a 2017 study concluded that CBD can reduce osteoarthritis-related pain and inflammation, and prevent nerve damage.
Other studies support CBD for relief of neuropathic pain and incision-related pain. CBD’s effectiveness at relieving different types of pain has led to its popularity among people with conditions such as fibromyalgia, IBS, multiple sclerosis, and cancer.
CBD has powerful anti-oxidant properties, which also help to support the immune system. Although not considered psychoactive, it can help with the depression, and anxiety sometimes a side-effect of chronic pain.
In one animal study on arthritis pain, it was found that the topical application of CBD led to a reduction in inflammation and pain.
CBD or THC: Which is Better for Pain Relief
While cannabis plants are complex and different varieties have different chemical compositions, almost all of them contain some combination of two medically important compounds: THC and CBD. By far, the most notable difference between CBD and THC is that THC causes a high, while CBD does not. CBD’s lack of psychoactive effects is one of the reasons it has become so popular as of late. These two chemicals both show potential in easing pain, but in different ways. Choosing a product rich in THC, CBD, or both could make a difference in the kind of pain relief you experience
“We know a lot more about how THC works in terms of the molecular mechanism [than CBD],” says Steve Alexander, associate professor of molecular pharmacology at the University of Nottingham Medical School, who researches cannabinoids.
“THC activates certain cannabinoid receptors, one of which is in the nerve cells and the other is in the immune cells. When it activates the one in the nerve cells, it reduces the sensation of pain,” he adds.
The high that THC provides can also play a role in how people experience pain.
“A little bit of euphoria can help us not care that we’re experiencing quite as much pain, much in the same way that other pain medications work,” says Angela D. Bryan, PhD, professor of psychology and neuroscience at the University of Colorado Boulder, who has studied cannabis and health.
CBD is much less understood than THC by researchers, although there is anecdotal evidence that it may provide pain relief in some people.
“We’ve got a hypothesis that CBD might have some interference with [the brain chemical] serotonin and some influence on glycine receptors, which may be involved with pain. We think it may do what it does by hitting multiple targets with a fairly light touch,” says Dr. Alexander. “It’s difficult to pick apart — lots of people are trying [to study it], but no one has yet succeeded.”
Researchers have not found much evidence that CBD can offer mental relief from pain. However, the placebo effect may help some individuals experience less pain after taking CBD.
“The human mind is a very powerful thing, and a lot of the ways we experience medication is related to our expectancies about that medication,” says Dr. Bryan.
There’s no definitive answer to the debate between THC and CBD for pain relief. Cannabis is still considered a Schedule 1 drug by the federal government — a legal status that limits the kinds of research that can be conducted. THC might not be an option for everyone, though. Some people may live in states where THC is illegal; while others simply don’t want the psychoactive effects of the substance. In those cases, it might be worth trying CBD on its own to see if it offers pain relief for you.
Before trying either substance, it’s worth considering potential side effects they may cause. Side effects of CBD include nausea, fatigue, and irritability, according to Harvard Health. CBD can also interact with certain medications (such as blood thinners) and either increase or decrease the concentration of certain drugs in the bloodstream.
THC has its own set of side effects, including sleepiness and lethargy, increased appetite, increased heart rate, coordination problems, dry mouth, red eyes, slower reaction times, memory loss, anxiety, and mood changes.
When looking to reduce your pain, you don’t have to make a choice between THC and CBD. In fact, it could be wise to combine the two. Researchers have found that cannabis really is a synergistic shotgun in the sense that all the compounds in the cannabis plant interact with each other.
Although the exact mechanisms for these interactions remain unclear, the most effective cannabis-based pain treatments have been found to contain a combination of both THC and CBD.
The entourage effect refers to the benefits that one can experience by ingesting multiple cannabinoids together, including CBD and THC. In short, while CBD and THC have their own powerful benefits, they tend to be more potent when combined – especially when it comes to pain relief. An analysis of 18 studies on cannabinoids for multiple sclerosis pain found that the combination of THC and CBD was slightly more effective for pain reduction than CBD on its own.