Is intramuscular or smoked weed the future of managing pain?

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Some suggest happiness is all about increasing pleasure and limiting pain. As such, pain is a pressing issue in many people’s lives. Whether that pain is chronic or acute, it can be debilitating. And because of that, at least in part, millions of people in the U.S. and elsewhere find themselves relying on opiates.

Still, research is pointing towards some alternatives. Following up on 2018 research that found cannabinoids may up a patient’s pain threshold while alos making pain seem less unpleasant, a December 2020 meta-analysis comprehensively reviewed available medical literature on cannabinoids and acute pain.

Differences in administration count

After searching the available data, the analysis selected six studies: two from the U.S., two out of Canada, one from the U.K. and one that featured contributions from Germany, Italy and the U.K. Five of them studied orally administered cannabinoids, while one explored the effects of intramuscular cannabinoids.

Throughout the research, the group given orally administered cannabinoids did not differ significantly from the controls, who were provided a placebo, but the intramuscular patients saw a significant improvement in acute pain.

The analysis went on to posit that this may be the result of differences in the metabolization of cannabinoids administered in various ways. “Specifically, oral absorption of cannabinoids is slow and variable with maximal plasma concentrations occurring 60 to 120 minutes post-ingestion, but can be delayed upward of six hours,” the study noted.

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Throughout the research, the group given orally administered cannabinoids did not differ significantly from the controls. / PHOTO BY DEAGREEZ / ISTOCK / GETTY IMAGES PLUS

“Cannabinoids are subjective to significant first-pass liver metabolism, which further reduces the bioavailability. Utilizing transdermal, inhaled or oral transmucosal formulations allows for direct plasma uptake and avoidance of the first-pass effect. Inhaled cannabinoids reach peak effect in 10 min and plasma levels are maintained for several hours,” study authors pointed out.

Here, the available data seems to suggest that alternative methods to traditional oral consumption methods may be more effective at treating pain. Water-soluble oral administered cannabis may also be an adequate alternative as it also has a faster activation time.

That said, cannabinoid-based treatments did increase the presence of certain adverse effects. It did not, however, increase the presence of severe adverse effects, which may support its potential as a treatment method for acute pain.

The study concludes by noting that all of the studies were focused, if not solely based, on THC. While THC has a strong potential as a pain reliever, CBD is also a viable research candidate for novel treatment methods.

Competitive and varied markets are fertile environments, and so expanding and exploring cannabis as a medicine could help enrich science and empower the consumer.

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