More than three-dozen states and the District of Columbia have decriminalized medical cannabis. Among the most common reasons for recommending medical cannabis is chronic pain. People who use marijuana to self-medicate swear that it relieves their pain. Medical science isn’t so sure. Who do we believe?
It’s an important question given the results of a study released in late 2022, a study that says marijuana performs no better than placebo as a pain reliever. Seizing on the results of that study would dictate that we stop promoting marijuana as a pain treatment because it doesn’t actually do anything we can measure. But before we go down that road as a society, there are a number of other things to consider.
Is placebo a modality itself?
When it comes to new drugs, procedures, and therapies, modality is a legitimate question. Modality in medical science is essentially the means by which a particular therapy works. The modality behind steroids for relieving pain is found in their ability to reduce inflammation.
With that understanding, it is reasonable to ask if the placebo effect is a modality itself. Remember, one of the arguments against marijuana as a pain therapy is that it performs no better than placebo. But numerous studies over the years have suggested that OTC pain medications do not necessarily perform better than placebo, either.
One such study, published in 2017, concluded that neither aspirin nor ibuprofen provided any more pain relief for back pain as compared to placebo. And yet no one questions a person who claims pain relief after taking a couple of ibuprofen tablets with a glass of water.
If It Works, It Works
Even if the placebo effect is largely behind the pain relief experienced when using OTC pain medications, does it really matter? You take some ibuprofen or aspirin, and you feel better. As long as the medication isn’t physically harming you, hasn’t the mission been accomplished? Pain relief is pain relief.
The same thing can be said about marijuana as a pain therapy. For the sake of argument, let us say it doesn’t actually do anything in a physiological sense. Let us say all the pain relief benefits marijuana patients claim to experience are only the result of the placebo effect. That shouldn’t matter. They are finding pain relief with a medication that poses little to no threat of harm.
Would patients use something that doesn’t work?
Chronic pain is the most common condition for which medical cannabis is recommended, according to the experts at Utahmarijuana.org. Now, you could make the case that there are probably a certain number of medical cannabis users who complain of chronic pain, even though they don’t actually experience it, just so that they can legally buy and use marijuana.
On the other hand, what do you do with studies that show large numbers of verified chronic pain patients choosing marijuana over other therapies? One such study was published by the Journal of the American Medical Association in early 2023.
According to that study, more than 30% of the surveyed patients reported using marijuana to relieve their chronic pain at some point. This is not to say that all of them used marijuana exclusively, but they did use it. Would chronic pain patients use something that doesn’t work? Maybe initially, but not persistently.
On the one hand, we have certain members of the medical community saying that marijuana is no good as a chronic pain therapy. On the other hand are the countless numbers of marijuana-using patients who swear by it. Who do we believe when opinions are so divergent?