Chronic pain : CBD or THC or both?

[bkpnsux]

Hello everyone, first of all I wanted to say THANK YOU to the owner(s) and moderator(s) of this forum as well as all the very helpful members here. I've only been a member here a short time but I can already tell this is an excellent forum with a wealth of knowledge.

Ok, now to the purpose of my post.

I have back issues which have resulted in chronic pain for the last ten years. I've been lucky enough to avoid any of the hardcore pain meds thus far, however my back pain has gotten progressively worse and about a month and a half ago my doctor suggested he write me a prescription for percocet or oxycontin.
My body does not like opiates at all, and I wanted to pursue something more natural.

I asked my doctor about mmj, and he agreed it would be a good alternative to opiates, however he also said he is not trained in mmj and did not want to write the 'script but would refer me to an mmj doctor here in Ontario (Canada).

To make a long story short, I saw a specialist who prescribed Tramadol (which I haven't filled yet, I'm hoping to find natural pain relief) as well as writing me a prescription for mmj, however he put a restriction on the strain to contain the lowest possible THC level.

Prior to about a 3 weeks ago I had very little experience with weed. I don't smoke and have had asthma issues in the past.
3 weeks go I purchased an Ariza extreme Q, and actually bought some marijuana off a guy I used to work with (when still able to work). The "street" weed when vaped gave me pretty good pain relief however it wasn't practical for daytime use (too high) but I slept great at night for the first time in a long time.

My question is: from what I've read CBD is best for many ailments but not so much for chronic pain but works best when in conjunction with THC for pain, if at all. Is this correct?

I've read about several strains at leafly and from what I understand THC is best for chronic pain but is best tempered with cbd to counter act the high so one can function normally.

Is the above statement correct?

My dispensary is Aphria and the strain the doc prescribed in "Wilbur" (THC: 1.93% | CBD: 5.86%) which isn't really doing much to help with my pain.

I'd love to hear any stain suggestions from anyone dealing with chronic pain that has a good strain for daytime use and what the usey in the evenings. Particularly if you are in Canada as well because I'm limited to Canadian dispensaries.


Thank you for taking the time to read my post!

 

[OldOyler]

@bkpnsux ,

Well, you are under the care of a physician so let me say I only feel comfortable relaying my own experience. Communication (relentless to some degree if need be) with both the doctor AND the dispensary can help get issues "shaken loose" and solved.

:-)

I can relate - my primary story is chronic pain (disabled) from double peripheral neuropathy (sorry sir, those 7 back surgeries have now permanently left you feeling like the discs are herniated forever. Sorry, now get out and see pain mgmt).

12 years ago was my last opiate day - 600mg oxycontin daily.

I ran backwards through the formulary with everything non-narcotic after that, until the epidural steroid injections - SURPRISE - had begun osteoporosis (sp?) in my spine near the injection sites.

I believe the next available treatment backwards on the list was "Bleedest thou the patient with leeches"....

Anyhoo....

I have found that not only do I do better with a respectable amount of THC, but that I do better with the "whole product". I personally make my own RSO (Rick Simpson Oil) and have done better with sublingual oil for pain.

Perhaps check with the dispensary *first* to see what they carry, then go back and speak to your doctor about it? Remember that the medical community, though now open to cannabis prescribing, were still taught to prescribe a single active ingredient in a medicine for a single "symptom", and so on. They see "THC" as one medication and "CBD" as another. It is why I still refer to the oil I use as "Rick Simpson Oil" instead of the more general "Cannabis Oil". Because I also subscribe to the other things he said about *why* cannabis is so healing, and how much resistance we can expect from the medical professionals - even those trained (and willing) to prescribe MM, and he felt strongly that there were many things in there that we just don't know about yet, but shouldn't ignore.

And sorry it took me so long to reply, I hadn't seen your post until today. I will keep it on my "watched threads" list to see how you make out!!

Peace and healing to you,

OldOyler

 

[max]

"In 2009, an international team of investigators from the United Kingdom, Belgium and Romania affirmed these preclinical findings in a clinical study of intractable cancer pain patients. They concluded: "n this study, the THC/CBD extract showed a more promising efficacy profile than the THC extract alone. This finding is supported by evidence of additional synergy between THC and CBD. CBD may enhance the analgesic potential of THC by means of potent inverse agonism at CB2 receptors, which may produce anti-inflammatory effects, along with its ability to inhibit immune cell migration. ... These results are very encouraging and merit further study." http://norml.org/library/item/chronic-pain

 

[bkpnsux]

OldOyler thank you for your response. I'm in Canada so unfortunately for me I can only order dried MMJ and if I want concentrates or edibles I'm on my own.

Thank you for telling me your story and I'm glad to hear Cannabis has been helping you do better.
My situation is a bit different in that I'm not looking at MMJ as a last resort when all else fails but more as an alternative to pharma pain meds.

Unfortunately because of the this high CBD strain not providing any relief I've had to start with Tramadol and that's only providing partial relief (granted the doc prescribed a lower dose to see how I do with a higher dose starting next week.).

I'm really hoping to get my prescription sorted out next week and get something in place of the Tramadol. Pills scare the crap out of me.. Very concerned about getting hooked.

I am definitely happy to have been prescribed MMJ and I'm optimistic if what you are doing is helping you after taking 600mg Oxy/daily then there has to be a something out there for me.


Max - Thanks for your response. I understand the benefits of CBD to a degree and I know it's done wonderful things for seizures, etc etc but what I am curious about is for pain specifically is THC better than CBD or is a combination of both what is required? CBD on it's own hasn't done anything for my pain at all so far, but then again the doc prescribed a strain with just over 5% CBD.. so maybe I need more...?

Some of the sources I've read state high levels of THC for chronic pain, others recommend CBD and I've also read that certain strains with specific combinations is the key.. So I'm not sure where to start. I can rule out CBD on it's own though.. (at least at that %).


Thanks guys and I wish everyone good health

 

[OldOyler]

what I am curious about is for pain specifically is THC better than CBD or is a combination of both what is required?

A quick FYI with *no* snyde remark intended - that link from @bkpnsux so *very* much answered that question. It was an excellent article.

Like, here's a quote from it you could take to your doc: "A 2013 clinical trial reported that both inhaled cannabis and oral THC significantly decreased pain sensitivity and increased pain tolerance in healthy subjects exposed to experimental painful stimuli.A 2013 clinical trial reported that both inhaled cannabis and oral THC significantly decreased pain sensitivity and increased pain tolerance in healthy subjects exposed to experimental painful stimuli.".

So that was about THC's effects on pain, not CBD, just as far as "balanced statements" go.

I only brought it up because *we* need to be informed if we expect our medical professionals to be informed. Read, read and read my friend.

I didn't for a while, and I would take a quick look at the quote from a post or something, but not really read it in depth - and I continue to be a big offender of that, *and* I should know better. :-)

That article could be *huge* because it is heavily peer-reviewed. Big deal to doctors, especially. So let that article be your "starting point" - because you are clearly able to think about this at a pretty precise level, I think once *you* find the answer, the one that *you* believe, you will be well on your way to convincing any medical professionals in your care to at least take a look at modifying your treatment.

I realized for myself that "Hey doc, what about cannabis in this way or that..." was a subtle and unconscious cue to the doctor saying "I don't know" and also "So it's *your* expertise and experience I am relying on". So they did exactly that.

Once you know your conclusion in depth, my friend, you will not only find more open minds from medical professionals - you will find that you have given those same professionals knowledge and experience to treat the *next* patient that doesn't know and is relying on the doc's expertise and experience.

Hurray!

(Again, all meant in the highest respect, in the humblest of manners!)

Peace and healing!

 

[Jeppy]

Get GDP. It is usually available everywhere. Great for chronic pain. You can always mix strains. Mix your cbd strain with others. Vape only enough to give relief.

 

[archangelz001]

I looked at the Aphria site. You might do better with a strain that has THC and CBD more evelny balanced like the Athabasca, or Penny Wise, strain. It has 6.78% THC and 5.85% CBD. The balance is such that you will get the pain relief of THC, and the CBD should mitigate unwanted psychoactive effects, as well as contribute to pain relief. Then the next issue would be to find the right dose that gives you relief. 0.05-0.10 gram might be enough for some people, and others might need 0.5 gram or more. Best wishes..

 

[bkpnsux]

Thanks guys, I appreciate the input. I hope to get my prescription changed soon and will try a couple mixed strains.

My hope is to have two strains, one hydrid heavier in CBD for daytime and one indica higher in THC for nighttime relief. I've been in contact with a gentleman from a licensed dispensary other than Aphria and he's been very helpful. I think I'm going to switch over to his dispensary. They also sell 5 gram bottles so I can experiment a bit with different strains without having to spend too much in one shot.

Jeppy - pardon my ignorance.. GDP? Grand Daddy Purple?


Thanks!

 

[Jeppy]

Thanks guys, I appreciate the input. I hope to get my prescription changed soon and will try a couple mixed strains.

My hope is to have two strains, one hydrid heavier in CBD for daytime and one indica higher in THC for nighttime relief. I've been in contact with a gentleman from a licensed dispensary other than Aphria and he's been very helpful. I think I'm going to switch over to his dispensary. They also sell 5 gram bottles so I can experiment a bit with different strains without having to spend too much in one shot.

Jeppy - pardon my ignorance.. GDP? Grand Daddy Purple?


Thanks!

Yes that is correct. I personally mix indica and cbd at night. Cbd is especially good at night for nuerological disorders which are exacerbated at night, upsetting normal sleep. I use predominantly 2 strains now. acdc and pennywise. Expect to do your research.

 

[woolspinner]

CBD may enhance the analgesic potential of THC by means of potent inverse agonism at CB2 receptors, which may produce anti-inflammatory effects, along with its ability to inhibit immune cell migration.

I found this interesting. Supportive of the idea that the cannabinoids work together. THC alone may not have the same effect as THC coupled with CBD. And one could presume the reverse is true.
In a recent dispensary visit where a friend bought a CBD tincture that also had a smaller amount of THC, the budtender said CBD is more effective with a little THC. She said this without referencing any studies or clarifying in what way (pain management, anxiety management?) CBDs effects are boosted, but drawing a correlation between the study you quote and what she said is not stretching far.

 

[max]

I found this interesting. Supportive of the idea that the cannabinoids work together. THC alone may not have the same effect as THC coupled with CBD. And one could presume the reverse is true.
In a recent dispensary visit where a friend bought a CBD tincture that also had a smaller amount of THC, the budtender said CBD is more effective with a little THC. She said this without referencing any studies or clarifying in what way (pain management, anxiety management?) CBDs effects are boosted, but drawing a correlation between the study you quote and what she said is not stretching far.

I don't know, but I do know that in general, it's not good when humans start fucking with, and altering Mother Nature. For example, you don't find Calcium in nature without the presence of Magnesium, and taking a Calcium supplement without Mag is counter productive. It's certainly something to consider.

 

[shortwind]

My spine has stenosis, osteoarthritis and degenerative disc disease. I also have osteoporosis and am a severe asthmatic with a long history of oral predisone use during extended (six weeks or more) flare-ups. I have also had avascular necrosis in one hip, resulting in a hip replacement and revision of the hip replacement in less than a year (the AVN likely from the prednisone use). My pain is worsened by standing, walking, squatting, etc. I have days when the pain is tolerable, but consistently flares up after too much activity (pretty normal stuff like shopping at a department store). I do physical therapy and other exercises daily...but in moderation. I also get up and walk briefly a lot when I'm sitting to prevent too much stiffness. Basically, a moderate amount of structured exercise for me is good, but too much is bad. But now to my topic. I have been able to use cannabis (primarily indicas) for my everyday pain...such as after too much standing, walking. I now have a seated rolling walker to rest in when I have a lot of walking/standing to do. It helps ease the pain. In the last few months, I have had a new sciatic on my left side. I have had sciatic on my right side for many years...and some 10, 11 years ago it started and I was able to get it under control with physical therapy and muscle relaxants. It still flares up, but in a more tolerable version. That was long before I used MM. The new left sided sciatic has flared up about 3 or four times now since it debuted in March. Unfortunately, it creates sharp stabbing intense pain that no re-positioning of my body, rest, or MM seems to help. I have had to turn to hydrocodone to knock the pain down. So far, I can get it under control in about a day and a half to two days with the pain pills and rest. As an experiment, I tried some high CBD honey sticks (3) from a local dispensary. These were sticks were with little or no THC (normally I use only THC variety cannabis). This was on the day when the sciatic pain had reached a more tolerable level. Results? NADA. NO PAIN RELIEF WHATSOVER. This was very discouraging as I hoped to find pain relief without a psychoactive effect for times when I am driving or at an event where I want a non-altered mind state. I keep hearing all the hype about CBD's wonderful pain killing properties (I have also tried a CBD tincture, again without success). Is it that my type of pain is resistant to it or? Oh, FYI, I vape and use tinctures and cannabis infused coconut oils, other cannabis oils and some other random edibles as I cannot do any combustion due to my crappy lungs. I am in a medical state and have a grower...so I am limited to my strains...I always ask for indicas, though. I have chronic insomnia and that has been my primary use of the medicine until the pain issues became more persistent.
I am afraid that if the sciatic pain becomes more chronic that I will have to use opiates more often...something I do not want. Any suggestions? And why was the CBD so ineffective? I am in Oregon, so I have a lot of access and am legal patient.