Strains of cannabis may come with names like Purple Diesel and Blue Sky. While the term “strain” is commonly used by dispensaries, medical cannabis users and even physicians, it’s not a term used for plant nomenclature. 9 A strain name may come from a grower, producer, processor, or dispensary. A 2018 study out of Washington state found that commercial Cannabis strains fell into three broad chemotypes (chemically distinct plants that otherwise appear indistinguishable) that were defined by the THC:CBD ratio. 10
Medical cannabis is currently legal in 34 states (as of spring 2019), many of which require patient registry or identification cards for the purchase and use of the substance for specific diagnosed medical conditions. These conditions differ by state and continue to change. At the federal level, marijuana is classified as a Schedule I substance under the “Controlled Substances Act,” and there are no recognized medical uses. In many of the states with legalized cannabis, some type of product testing is required, however, testing varies by state and may be limited contamination tests or may include quantification of CBD and THC levels.
Chemically speaking, cannabis is complicated. To date, 568 unique molecules have been identified in the cannabis; of these, more than 60 are cannabinoids — these are compounds that act on receptors in the body’s endocannabinoid sy stem. This system plays a key role in endogenous pain control. 4
“There is little consistency in plant constituents between products’ strain names,” said David Bearman, MD, a physician in private practice who specializes in pain management and has more than 40 years of experience in managing substance abuse. “These names are mainly marketing tools and tell little about the constituents of the product. The best advice is to read the label and understand it.”
A growing body of clinical research and a history of anecdotal evidence support the use of cannabis for the relief of some types of chronic pain, including neuropathic pain, and spasticity (ie, stiffness or tightness) associated with multiple sclerosis. 1 In a recent comprehensive review of existing data on the health effects of cannabis and cannabinoids, the National Academies of Science concluded that adult patients with chronic pain who were treated with cannabis/cannabinoids were more likely to experience a clinically significant reduction in pain symptoms. 2 They rated these effects as “modest.”
Research has shown that activating the CB2 receptor seems to be beneficial in managing chronic pain, which doesn’t often respond well to other therapies.3, 4 Since CBD attaches to this specific receptor, it may be helpful in activating the pathways that ease the chronic pain, often associated with long-term or degenerative conditions such as fibromyalgia, multiple sclerosis, and diabetes.
Cannabis indica is short plant and densely populated with broad leaves. This species is often referred to as marijuana since it contains up to 30% of the psychoactive cannabinoid, THC, which can be harvested from its flowering tops for its euphoric properties. Cannabis indica naturally contains very little CBD, which counteracts the psychoactive properties of THC; however, some strains of marijuana can be bred to promote higher levels of CBD. Commercially growing high-CBD strains of marijuana for medical use has remained controversial but is becoming more acceptable on a state-by-state basis.
Cannabis sativa L. is a taller and more narrow species, relatively low in THC (approximately 0.3% or less) but rich in CBD, which is harvested from the oil of the seeds and stalk fibers. This species is traditionally known as hemp, and like medical marijuana, is grown commercially under controlled conditions. It may sometimes be referred to as “industrial hemp” because it can be harvested for a variety of commercial uses.
CBD for Chronic Pain Management
Chronic, widespread pain originating from a dysfunction in the central nervous system is characteristic of fibromyalgia. Some researchers have suggested that a deficiency in the endocannabinoid system, which governs pain sensitivity in the central nervous system, may be involved in the lowered pain threshold, and mood and sleep challenges that accompany fibromyalgia. In cases where heightened pain sensitivity was arising from a depression of the endocannabinoid system, treatment with cannabinoids reduced the pain sensitivity, as expected.6 In other studies, individuals with fibromyalgia experienced significant relief from pain, sleep disturbances, stiffness, mood disorders and anxiety after using cannabinoids further supporting its possible use in this chronic pain condition.7
Natural botanicals with anti-inflammatory pain-relieving compounds, including turmeric (Curcuma longa; a source of curcumin) and frankincense (Boswellia carterii) began gaining attention. Among these natural therapies, rose a very effective compound – cannabidiol (CBD) – but its familial connection to marijuana shadowed it with caution and political debate. Its popularity has continued to gain momentum as the courageous have sought to untangle CBD from its psychoactive cousin, THC, and make it an acceptable tool for some of the most stubborn cases of chronic pain.
CBD (cannabidiol) is a cannabinoid compound extracted from the cannabis plant. Various Cannabis species exist and supply over 100 cannabinoids, but medicine has focused primarily on either tetrahydrocannabinol (THC) or cannabidiol (CBD) for pain management.
CBD from Hemp or Medical Marijuana?
Cannabinoids such as THC and CBD have been studied extensively for their use in various chronic pain conditions, but are especially helpful agents for controlling neuropathic pain.2 This is chronic pain of the nerves that waxes and wanes, and may even lead to tingling or numbness, such as complex regional pain syndrome (CRPS), formerly called reflex sympathetic dystrophy (RSD). It often arises as a result of peripheral nerve injury, but can be mediated by other factors, also.
Both CBD and THC act upon a comparatively recently discovered communication system in the body, known as the endocannabinoid system. This system is laced throughout the central and peripheral nervous system. The complex nature of this system is still being researched, but we know there are two primary receptors through which THC and CBD can attach and carry out their effects on the body. One receptor is called CB1 and when activated by a compound such as THC, it stimulates pathways that promote the mind-altering effects associated with traditional marijuana. The second receptor is called CB2 and when it is activated by a compound such as CBD, it not only helps to ameliorate the actions of CB1, but helps the body manage pain.1
Rehabilitation therapy is an exercise program for CRPS and helps to keep your limbs moving and improve blood flow. By increasing your blood flow, you can decrease the impact of the circulatory symptoms you are experiencing. These exercises can improve your strength, flexibility and the function of your limbs.
CBD is shorthand for cannabidiol which is a chemical that is contained within the cannabis plant. CBD doesn’t get you high, unlike the most notorious cannabinoid THC (tetrahydrocannabinol). The primary difference between CBD and THC is that CBD doesn’t directly interact with the endocannabinoid system, which prevents it from causing the user to feel high or intoxicated.
By elevating the 2-AG endocannabinoid, CBD can help with inflammation with the same process it uses to help with pain and retrograde signalling. The 2-AG endocannabinoid tells the CB2 receptors to desist in sending out so many attack cells without compromising the strength of your immune system.
CRPS is an elusive illness which is hard to diagnose, and it is difficult to definitively treat. CBD and medical cannabis could present an excellent solution to CRPS patients, and the side effects are substantially less than horrific medications such as opioids. This means that the medication that the patient uses over an extended period does not have a detrimental long-term effect on their health and is not addictive.
CRPS is shorthand for Complex Regional Pain Syndrome for which the most prescribed medications can be addictive or harmful if they are used for an extended period. Therefore, an increasing number of people are turning to CBD and medical cannabis to try to treat their symptoms of CRPS. CBD is not addictive, and a tolerance doesn’t develop over time. It is important to note at this juncture that CBD does not get you high or have any psychoactive impact on the user.
○ Changes in the temperature of your skin
○ Minor medical procedures