side effects

Chronic Pain: Opioids & Cannabis

Opioids vs. medicinal cannabis: comparing the short-term side effects

The United States is currently in the midst of what is being termed an ‘Opioid Overdose Crisis’ where every day, more than 130 people die after overdosing on opioids in both prescription and illegal forms.

Opioids are defined as a class of drugs including the illegal drug heroin, legal prescription drugs for pain relief such as oxycodone, morphine and codeine, and synthetic opioids such as fentanyl. Their primary application is for the management of acute and chronic pain conditions.

The current ‘Opioid Crisis’ is thought to have begun in the late 1990s after pharmaceutical companies assured the medical community that patients could not become addicted to prescription opioids, leading many healthcare providers to prescribe them at a greater rate. This then led to large scale misuse of these drugs before it became apparent that these medications could become highly addictive.

Since then, overdose rates have steadily increased, with The Center for Disease Control and Prevention now estimating that the total economic burden of prescription opioid misuse in the U.S is around £78.5 billion a year when healthcare, lost-productivity, addiction treatment and criminal justice costs are taken into account.

With an issue as serious as the opioid crisis consistently in the press, it is crucial to delineate the differences between highly addictive opioid painkillers and medicinal cannabis, which is also used for pain relief purposes.

Medicinal cannabis

A key difference between the two substances is that medicinal cannabis products, especially those typically prescribed with high CBD and low THC balances, have very few if any side effects for the majority of people. Those users with a marked sensitivity though, around 3% of users, may initially be recommended lower doses.

Nonetheless, some side effects that can be experienced with CBD based products include:

  • Drowsiness
  • Dry mouth
  • Light-headedness
  • Mild hypotension
  • Gastrointestinal upset

The side effects of products with higher levels of THC are also generally minimal or non-existent, particularly if medical advice is properly followed and a ‘start low and go slow’ method of dosing is adopted.

However, short-term side effects of products containing larger amounts of THC still sometimes include:

  • Disorientation and dizziness
  • Euphoria
  • Drowsiness
  • Dry mouth
  • Balance problems
  • Hallucinations
  • Nausea
  • Paranoia and anxiety
  • Depression (although it must be noted that THC can also be used to treat depression)
  • Psychosis, depersonalisation and delusions

Psychosis and an increased heart rate or cognitive problems are most commonly effects of a THC overdose. Yet, it is crucial to remember that nobody has ever been reported to have died from a cannabis overdose. As such, it is generally understood that overdose effects will pass, with the best method of treatment being to simply remain calm and wait for the effects to subside.

Opioids

Unlike medicinal cannabis, more severe side effects are entirely common with opioid therapy, with 50-80% of patients suffering with at least one side effect in clinical trials. Obviously, in uncontrolled everyday use these incidences may be even higher. Indeed, detrimental side effects often lead to the discontinuation of opioid therapy.

Specific side effects associated with opioid use include:

Obviously, further morbidity factors must also be considered when looking at opioids, including the percentage of patients who are prescribed opioids who misuse them and the number of patients who misuse prescription opioids and then transition to heroin as a result.

Cannabis- based products may be, despite the limitations on their prescription in many jurisdictions, a safer and more viable option for chronic pain management than typically-used opioids, particularly when short-term side effects are considered. However, while properly managed opioid painkillers do still represent highly effective acute pain management drugs.

What do you think about the potential use of cannabis rather than traditional opioid treatment? We’d love to know what you think in our comments.

Further investigation and research into cannabis use (both recreational and medical) is thoroughly encouraged by The Academy, particularly through the use of our own online coursesevidence base and whitepapers.

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