Pain Management and Cannabis

Cannabis for Pain

The status and use of marijuana in the United States has taken some rather circuitous and different paths. For many years, the dealing or possession of cannabis in any form has been a ticket or a trip to jail for many people. To this very day, marijuana and cannabis remain Schedule I drugs, meaning that they have "no medical use" and thus should never be possessed or used by anyone. However, the legalization of cannabis in many states, sometimes even for recreational uses, and the corresponding permissiveness from the federal government as well as medical trials and tests relating to cannabis have shown that the tide is starting to turn when it comes to the perceptions and reactions to cannabis and legitimate uses that may exist. One such use is for pain.

Statement of the Problem

One significant reason why the studying of cannabis for pain management has come to light is that it can serve as supplement or even a replacement for opioids. Given the addictive properties of opioids and the destruction that is left from such addiction, this has become a clarion call to study and implement the use of cannabis as a means to mitigate or even prevent addiction to opioids. Just a few examples of diseases and disorders that are in play here include non-cancerous chronic pain conditions and pelvic pain in men (Tripp et al., 2014; Degenhardt et al., 2015)

Research Questions

Given the background and introduction that has been covered thus far, the research questions surrounding the study to be completed are as follows:

• In what situations can cannabis be used as a way to lower the use of opioids?

• In what situations can cannabis be used to replace opioids?

• Are there some disorders and issues where cannabis is not currently seen as a viable replacement?

• Are there situations where cannabis actually performs better overall than opioids?

Hypothesis

Null Hypothesis: There is no benefit of using cannabis in the place of opioids because the latter performs better than the former when it comes to pain management

Hypothesis I: There is some benefit to medical cannabis as compared to opioids but cannabis does not replace opioids entirely when it comes to pain management

Hypothesis II: There are at least some situations where opioids can entirely be replaced by cannabis with an equivalent or even better overall effect

Operational Variables

When studying and assessing the efficacy of medical cannabis, the obvious variable of focus will be the efficacy of cannabis versus that of opioid in the same or similar conditions. For example, if there is a pool of one hundred people that suffer from the pain of fibromyalgia, half of the group could be given the cannabis treatment while the other half could be given the opioid treatment. After a round of treatment and drug administration, the positive and negative effects of each group over the same period of time but with the different drugs can be compared and contrasted. Ergo, the fibromyalgia (or whatever disorder is being studied) would be the dependent variable whereas the drug used (cannabis or opioids) would be the independent variables. It would be assessed to what manner and degree each of the independent variables (the drugs . . . cannabis or opioids) affect and change the dependent variable (fibromyalgia). If one does better than the other in terms of treatment, then this would tend to indicate which one should be used between the two. However, one consideration with cannabis versus opioids is that opioids are very addictive and their efficacy is reduced over time. As such, even if the cannabis intervention is lesser in efficacy, it should still be considered part of the toolbox that doctors and clinicians use since the chances of addiction and lesser chances of an overdose are without question. The point is that his research question is not black and white. Even so, cannabis must prove it has positive effects for it to be something that can be recommended and pushed. Something that has to be remembered, however, is that the administration of the drugs does matter. Just because one form or use of a given drug does not work does not mean that the drug will also not work in another form. For example, cannabis can be given in one shot or it can be vaporized, in addition to the more commonly known uses of the drug such as smoking or edibles (Wilsey et al., 2013; de Vries et al., 2016). For each disorder or situation, it is important to be both fair and exhaustive. This means tinkering with what precise formulation is being used, what dosage is being used, what timing between dosage is used and so forth.