Medical Cannabis, Chronic Pain, and the Placebo Effect

Medical Cannabis, Chronic Pain, and the Placebo Effect

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It is well known that the most common condition cited by patients who use medical cannabis is chronic pain. On the one hand, we would expect this to be true given what we know about cannabis history. On the other hand, there are questions about the drug’s effectiveness at relieving pain. Is the relief real or just the placebo effect?

A meta-analysis study published in November 2022 created waves in the pro-cannabis community by suggesting that cannabis is no better than placebo at relieving pain. Their counterparts in the anti-cannabis community seized on the study as proof that medical cannabis is a fallacy. Both made compelling points in defense of their positions. But perhaps everyone has missed the point entirely.

Clinical Trials Don’t Reflect Reality

The meta-analysis in question looked at the results of 20 previous randomized controlled studies that included more than 1,400 participants. Most of the participants were either multiple sclerosis patients or patients suffering with some form of neuropathic pain. Participants were treated with THC, CBD, several prescription medications, and placebos.

Researchers discovered that cannabis did not perform any better than placebo for relieving pain. The results were consistent across the entire body of studies they looked at. But they do not tell the whole story. In fact, all the studies suffer from one major flaw: clinical trials do not reflect reality.

In a 2022 blog post featuring comments from Harvard’s director of the Program in Placebo Studies, Ted J. Kaptchuk, author and Harvard Heart Letter Executive Editor Julie Corliss made a profound statement that says it all. She wrote, “But it’s a conundrum because a clinical trial is not real life.”

Kaptchuk’s comments echo that sentiment. He explained that cannabis is not alone in its questioned ability to relieve pain as compared to placebo. He explained that similar studies show that over-the-counter pain relievers, like ibuprofen and acetaminophen, do not fare any better than placebo. And yet we trust them implicitly as pain relievers. So what is going on?

All Drugs Interact With the Body

The one thing we can never forget when looking at the potential of the placebo effect is that all drugs interact with the body in some way, shape, or form. Sometimes those interactions seem to escape a scientific basis. But it does not always follow that a scientific basis doesn’t exist. It is entirely possible that we just haven’t found it yet.

Chronic pain continues to be the number one reason people use medical cannabis. That’s certainly true of the patients who turn to the medical clinics run by the organization behind the Utahmarijuana.org website. They assist patients in obtaining their Utah medical cannabis cards.

The medical professionals at Utahmarijuana.org explain that a serious lack of study since the 1970s has prevented medical science from fully understanding exactly how cannabis interacts with human biology. However, they say that Western medicine is familiar with the endocannabinoid system and the role it plays in regulating so many bodily functions.

If It Works, It Works

The point of all of this is to say that we should not put too much faith in clinical studies as the be-all and end-all of scientific evidence. Anecdotal evidence should be considered as well – and with equal weight. If medical cannabis offers patience genuine pain relief, does it matter how? If it works, it works.

Cannabis likely relieves pain in ways we do not yet understand. If we are going to accept the placebo effect as part of the equation for over-the-counter pain medications, it’s only fair that we accept it with medical cannabis as well.

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