How do I use cannabis for severe chronic pain?

Dear Dr. Dave,

Since December 2016, I have had three back surgeries and daily pain in the range of a 6 to 8 on a scale of 10. I am taking three different pain meds, but still have bad pain. What would you recommend? Is it better just CBD or a combo of both?

-Travis

Dear Travis,

Using cannabis, you can lower your opiate dose by 30-50 percent. We have a lot of positive experience (in my clinic) using both with high THC and a combination of THC and CBD in a 1:1 ratio. The dose of THC should be at least 15mg. At that level, you might want to add in CBD both for the anti-inflammatory effects and also the effects of balancing the euphoria associated with THC.

According to a discussion I had recently with a physician/herbalist, if you take a product with more CBD than THC, it doesn’t work as well as 1:1 or less. I have had some reports of people taking 25-40 mg of CBD a couple times a day and getting relief.

You may also want to incorporate the therapeutic use of the spice turmeric as well as the kratom leaf as both have analgesic (pain relieving) properties, but do not have the fatal side effects of opiates. Also, if you have an inner-spring mattress, you will likely get some benefit from a type with better support. Some chronic back pain patients have reported some benefit from mattresses that absorb shock with springs already built into the heel.

About the Author

David Bearman, M.D.

Dr. Bearman is one of the most clinically knowledgeable physicians in the U.S. in the field of medicinal marijuana. He has spent 40 years working in substance and drug abuse treatment and prevention programs. Dr. Bearman was a pioneer in the free and community clinic movement. His career includes public health, administrative medicine, provision of primary care, pain management and cannabinology.

Comments 5

Ben Kellerman

12.18.2018 at 7:54 am

Great to have a Professional helping others curious about safe self medicating. After my years of trial and error I found a higher THC of around 80% then a separate system for higher CBD dosage works better for me. Like all meds it is trial and error till you get it right.

robyn dennison

12.19.2018 at 1:34 am

this is a fantastic read

Tinkerbell

12.20.2018 at 9:43 am

Wow I’ve been taking 50 mg of CBD or more a day! I have been taking this for 5 months and the results are amazing! My nerve pain has gone down so much! I am now off of all opiates! Quitting smoking! Been smoking marijuana for a long time! It has helped a lot but CBD are changing my life! Not sure about the kratom have had reactions and so has my friend! I looked it up and you can die from it! Can’t die from marijuana or CBD! Need to have a high dose of CBD full spectrum to get the best benefits! Haven’t just learning this and now want to educate people! 15 mg is nothing 200mg is where I want to be at a day! Hopefully people will understand we have an endocannabinoid system and we have to fulfill it! Our government has been killing us with the pesticides I’m taking our help out of our lives! When people understand we need to have this hopefully people will get better! It is changing my life hope it does for others!