I want to try cannabis or CBD for chronic pain. Where should I start?
Q: "I’m 74 and have never used cannabis or CBD before. I have some chronic pain in my hands that affects my sleep, so I want to ease the pain to help me sleep. I’m wondering where I should start. Can a dispensary staff member help me, or should I consult a medical professional? Thank you for any insight you can provide."
A: Great question! As a medical professional I will always encourage you to work with a qualified healthcare professional. There are times when we can identify additional ways that cannabis may be helpful. A knowledgeable cannabis clinician should review at minimum your health history, cannabis use, medications, and goals of care. Cannabis can be complex, and it is definitely not a one-size-fits-all solution.
Having a clinician guide you can expedite your response and decrease the need to spend excessive money on products you may not need. While there are many knowledgeable dispensary staff on the frontlines of cannabis medicine, the industry as a whole has not developed standards of practice and training is optional in most places. That being said, it can be difficult to find a qualified cannabis clinician. Those who are knowledgeable about cannabis have sought out education on their own.
Clinicians are not taught about cannabis and there has been no standard of practice established for physicians or nurses or pharmacists.
Chronic pain is one of the most common reasons people explore cannabis as a medicine. In the US, approximately 40 per cent of adults have chronic pain. Opioids have fallen out of favor and many chronic pain patients are forced into mandatory opioid prescription reductions due to the potential overdose associated with use.
Pain affects many activities of daily living, especially sleep. Poor sleep quality may lead to increased anxiety and even increased pain. While some may not respond to cannabis for pain relief, most respond to it for sleep. Studies continue to demonstrate that cannabis and/or cannabinoids are effective for chronic pain and sleep disorders.
Without knowing your full health history, I would recommend starting with a topical. A topical application of CBD with THC can be applied directly to the hands to provide some relief and allow you to sleep. Since topicals do not penetrate the skin, side effects are unlikely. Most feel the benefits of a topical within 10-20 minutes and get relief for two to four hours. If the topical is not effective, I would seek professional guidance to see if you are a candidate for tinctures or other forms. Oral administration of cannabis may provide more relief and can last for four to six hours. Ultimately, it all really depends on many factors and while cannabis can be incredibly effective for sleep and pain, it may take some exploration with a knowledgeable clinician before you find the right regimen for you.
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Written by Eloise Theisen
Eloise Theisen, AGPCNP-BC, is a dedicated and patient-focused nurse. For over 17 years, she has specialized in aging, cancer, chronic pain, dementia, Alzheimer’s, Parkinson’s, anxiety, depression, fibromyalgia, and various autoimmune and neurological diseases. The founder of Radicle Health, she started her career at John Muir Medical Center caring for patients suffering from cancer, terminal illnesses, respiratory failure/complaints, drug overdoses, acute alcohol ingestion, gastrointestinal bleeds, traumatic brain injury, and multiple traumas.Full Bio