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An Introduction to Marijuana for Chronic Pain

Man experiencing back pain

What’s All the Hype About Marijuana Use for Chronic Pain?

Connecticut recently approved chronic pain as a qualifying condition for using medical marijuana. According to a 2019 study, more than 62% of people who use marijuana use it to treat chronic pain. Between the anti-inflammatory effects of CBD and the effects of THC, these compounds work together in an “entourage effect.” They partner together for significantly stronger efficacy than just hemp-derived CBD.

Chronic Pain Tops Medical Marijuana Use

Researchers in the 2019 study reviewed state registry databases to determine what medical conditions registered patients were using medical marijuana for. While they looked at data from more than 20 states, 15 states actually reported which conditions patients were treating.

Comparing this data to a 2017 report published by the National Academies of Science, Engineering, and Medicine, chronic pain stood out as the number one reason patients used medical marijuana.

How Cannabis Works for Pain

We all have an endocannabinoid system (ECS). “Endo” means inside and “cannabinoids” are cannabis compounds. We have cannabinoids already inside of us that our body naturally produces. And we have receptors for the cannabinoids to interact with.

This system helps the body establish and maintain balance for optimal health and wellness. The components of the ECS are expressed throughout the pain processing pathways. Cannabinoids like THC may enhance the efficacy of this system.

Here’s a little more information about how cannabis works for pain.

Anti-Inflammatory Properties

​​Inflammation typically causes pain because the swelling and buildup of tissue start pressing against nerve endings. This pressure sends pain signals to the brain, causing discomfort.

Inflammation is a large component of most pain. Evidence indicates that cannabinoids may contribute to pain relief through anti-inflammatory properties. Other components of the cannabis plant such as terpenes and flavonoids may also contribute to the anti-inflammatory effects of cannabis.

Mood Boost and Less Pain

Anandamide is an endocannabinoid commonly referred to as the “bliss molecule” because of the way it makes you feel. It’s notably found in chocolate, which may be one of the reasons chocolate is such a comfort food when we’re feeling down.

Fatty Acid Amide Hydrolase (FAAH) is the enzyme that breaks down anandamide. Some cannabinoids inhibit the FAAH enzyme. As a result, the breakdown of anandamide occurs slowly. This increases the levels of anandamide in the body, allowing the body to relax and experience less pain.

Communication is Key

One quality that sets cannabinoid receptors apart from other receptors in the body is their ability to conduct retrograde neuron signaling. That sounds pretty technical but stay with us.

Typically, one neuron sends a signal to another with information, but no information is returned. Anandamide is a retrograde messenger, which means that it can invoke a two-way (retrograde) communication system. The increased communication allows cells to receive information and respond according to signals received in the brain to promote balance. This includes pain signals.

Smoking Isn’t the Only Option for Using Marijuana for Chronic Pain

Inhalation and Sublingual

The most common method of consumption for marijuana is inhalation. This can be accomplished in a number of ways including smoking the raw flower, vaporizing flower or extracted oil, and through the usage of various pieces of equipment.

Inhalation and sublingual (under the tongue) consumption are the most bioavailable methods of using marijuana for chronic pain, meaning they offer the best absorption of cannabinoids like THC and CBD. Holding marijuana tincture under your tongue allows the cannabinoids to enter the bloodstream and avoid being metabolized in the liver.


Edibles are another option that come in many different forms. Capsules and tablets are considered edibles because they are ingested orally. Brownies, cookies, and other baked goods are classic forms of marijuana edibles.

Edibles take longer to digest but are often the most palatable for people who don’t enjoy the taste of marijuana. Keep in mind that edibles from a dispensary may range from 5mg THC to 200mg THC, so be sure to check with your pharmacist about the proper dosage for your chronic pain symptoms and goals.


Endocannabinoid receptors exist throughout the body, including directly under the skin. Most topical applications of THC are formulated to penetrate the transdermal layer to quickly ease soreness in muscles and joints. This allows for local relief, but without the psychoactive effects that are experienced from smoking or ingestion.

You don't have to be "high" to get relief. Though using marijuana for pain relief may imply that you will need to be “stoned” or “high,” that is not always the case. The psychoactive properties of THC come from the direct interaction with natural endocannabinoid receptors in the body. Stereotypical psychoactive effects may include changes in mood, drowsiness, cravings, and impaired motor skills. Many people find that small doses of marijuana for chronic pain have a significant impact without the red eyes or euphoric feeling. Researchers have also recommended starting with a low dose and increasing slowly to find your optimal level.

What Marijuana Research Means for You...

Because marijuana use continues to be controversial, studies like the one mentioned are significant. It becomes important however, that research in Connecticut looking at the various strains produced by our growers be supported.

Fine Fettle is committed to actively participating in medical marijuana research. Pain, chronic or otherwise, is very subjective. Our clinically trained pharmacists will work with you to determine which product will provide the relief that you are seeking for your pain.

Our Connecticut medical marijuana dispensaries are respectful, friendly, safe, and education-oriented. Our number one goal is to provide you with the medication you need and give you the knowledge and resources to best understand how marijuana can be a part of your medical routine for chronic pain or otherwise.

Source: Qualifying Conditions Of Medical Cannabis License Holders In The United States

Kevin F. Boehnke, Saurav Gangopadhyay, Daniel J. Clauw, Rebecca L. Haffajee

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