Pain Management Research Papers

Imagine being a caretaker for an elderly family member. It is a difficult but rewarding role keeping them comfortable and with other loved ones in their final years. Now, add in a crippling chronic mind-altering pain that loved ones must face. It makes them cantankerous and melancholy, no current pain management techniques work. To smoke, or not to smoke? This is a question that many people in pain must ask themselves. With the fairly recent legalization and decriminalization of marijuana in many different states, a new alternative pain relief is in the hands of the many. With years of propaganda and fear tactics used to keep marijuana illegal, finding extensive, long term, non-biased research studies on the effectiveness of tetrahydrocannabinol,
the active ingredient in marijuana, to combat physical pain can be arduous. To evaluate the effectiveness of tetrahydrocannabinol (THC) as a pain reliever there are three major considerations to take; the actual subjective reported pain relief, the risk of further dependence, and the side effects in comparison to other common opioid pain relievers. Pain relief is the most sought after and subjective medical need in the world. The word subjective according to Stedman (2005) in medical practice, refers to something only perceived by the patient and not evident or eminently quantifiable by the examiner. This becomes especially important when discussing pain, as only the person experiencing it can describe the type and severity. Different physical and mental ailments cause separate and distinct forms of pain. There are three broad categories of pain; somatic pain, visceral pain, and neuropathic pain. Each subset of pain and its location requires a different type of pain relief medication. A fairly recent development in genetics is the discovery of cannabinoid receptors in cells that manage pain (Guzman, 2015). This discovery gives a deeper understanding of why THC can be used to relieve an extremely broad spectrum of pains, as it does not target the specific pain but rather the bodies function of processing it. Sufferers of chronic neuropathic pain report, an almost two point, drop in pain on a 0-10 scale when using a modest amount of THC (Ware 2010). Not only is marijuana effective for a broader range of pains it seems to have a better subjective reported pain relieving property than many commonly used medications. One of the major problems associated with stronger pain relievers is the unbelievably high risk of dependence. According to the World Drug Report (2012) between 26.4 and 36 million people abuse opioid pain medications worldwide. The United States alone has an estimated 2.1 million people addicted and misusing these prescription pain relievers. This staggering number directly relates to the more than quadruple rate of unintentional deaths related to opioid abuse since 1999. The percentage of American citizens aged 12 and above that abuse pain relievers is more than 21 percent (NSDUH, 2015). The unintentional death rate related to marijuana abuse held steady at zero (CDC, 2016). When you compare this with the suggested estimate of 9 percent of THC users that become addicted (NSDUH, 2015), the odds seem to be stacked drastically in favor of medical marijuana. The last, but certainly not least, criterion that should be considered, is the adverse effects that users of pain relievers must contend with.
Side effects are an unfortunate necessity when contending with pharmaceutical practices. The idea of practicing safe medicine is a balancing act where the rewards outweigh the risks. In the case of pain management, this means that controlling the pain must be worth the inevitable myriad of effects that come with medication use. The more commonly used pain medications, belong in the opioid family. These medications also have a long list of side effects. According to (Benyamin, 2008) common side effects of opioid administration include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. Physical dependence and addiction are clinical concerns that may prevent proper prescribing and in turn inadequate pain management. Less common side effects may include delayed gastric emptying, hyperalgesia, immunologic and hormonal dysfunction, muscle rigidity, and myoclonus. The most common side effects of opioid usage are constipation (which has a very high incidence) and nausea. The most serious side effect that can occur is death. When using marijuana as a pain reliever the side effects that sufferers must contend with are; (WebMD, 2016) dry mouth, nausea, vomiting, dry or red eyes, heart and blood pressure problems, lung problems, impaired mental functioning, headache, dizziness, numbness, panic reactions, hallucinations, flashbacks, depression, and sexual problems. Most reported incidents of side effects related to marijuana use are extremely mild and occur infrequently and resolve themselves as the medication metabolizes. When basing a decision solely on the merits of how many and how severe the side effects are, then marijuana, again, comes out on
top. After taking into account how effective marijuana is at pain relief, how safe and mild it can be, and that the risk of dependence is so low, is it any wonder that THC is a superior pain medication. Based on marijuana’s effectiveness, with its merits alone, it would be a great pain medication; but when compared to the leading drugs used in medicine, currently, is when it really shines. Perhaps one day the medical community will wake up and look past the stigma attached to this wonder drug, and it will become widely available to all patients in pain.