I have pain… What strain is best for pain…? How do I treat pain with cannabis…?
Linda in Tucson, Kathy in Phoenix, Joyce in Mesa
I get a lot of questions about chronic pain, what strain is best, what works, how to dose for it and that sort of thing. I’m probably a reasonable person to report on it between my own use, working with hundreds of people over the years, and I like to geek out on reading cannabis research and/or unofficial research.
I have a rare genetic disease called Porphyria. I was quite sick for five years and then they finally figured out why. I got some weird treatment, it worked so I got a chest port and continued treatment for 15 years. I have recently tapered off my treatments, so now I am careful with myself and (fingers crossed) I am in remission. But the diagnosis comes with an emergency room tag that the pain levels are extreme and the protocol is some serious pain medications. I don’t take any. I was taking high levels of Demerol for a few years, but needed a new plan once the Doctors started talking about methadone as a pain management idea, and when I adamantly declined they gave me Fentanyl patches. That did not go well and I knew I had to figure out something different. They kept me on Demerol until I got up and going with treatments, which really helped a lot.
I have used cannabis exclusively and have not seen an emergency room for many many years. I utilize cannabis for both maintenance and on an emergency need basis. There have been many times that I would normally have needed to go to an ER but with my cannabis and rest I have avoided it.
So let’s talk about strains first. Some people think there is one strain that will help one thing. Like pills. Take this for your head ache, take this for sleep, take this for focus. But between variations of the plant and variations of growing style, toss in every person’s different metabolism, there is no one one strain to provide the specific cure all. You can find categories of strains that seem to help your specific needs; I don’t find that sativas help me with chronic pain but indica leaning ones do. That’s me. The heavier the indica the less aches. Hybrid for day time and full on indica for evenings.
Consumption is really the key. Edibles seem to be the longest lasting relief as they do provide what we call more of a “body high’, where your body feels it a bit more than your mind, if dosed properly. Making your own edibles will help you to have control over what plant matter you use in your medicine. We all can’t make our own, especially if you are already struggling with health issues. Making my own is what I do to get the very best results geared especially for me.
If you buy edibles try to find ones that specify if they are indica or sativa. I personally haven’t seen strain specific edibles yet but wouldn’t that be nice. This distinction on the package not only helps you determine how your day is going to go, but shows that the producer understands the importance of this information to the patient. This also tells me they are trying to help patients. I always lean towards companies who provide the best information as a way to support those concepts. I recommend newbies start low, you can always take more but you can’t easily reverse taking to much. There is a product called ‘undoo’, which can help reverse unwanted side effects of over consumption, I suggest keeping some in the medicine cabinet if you’re new to edibles. I love the medicated beverages.
I had a pain crisis recently and that required a different approach. I have pain all the time and I like to keep that in check with inhaling (I like a couple a bong hits) but when I have what I call an “attack” I can’t walk, move… you get the picture. I need something that works and fast. I have passed out from pain a few times, and while I so appreciate that my body just checks out when it gets crazy, I’d prefer to not. This is when I break out the Rick Simpson Oil (RSO, a very concentrated, gooey, dark – almost black – semi liquid form of indica cannabis) I keep in my medicine cabinet.
RSO works for my pain every time. I will admit I’m useless if I consume large amounts, but not anymore so then I would be if I had to make an emergency room run. Not to mention that I would have a hangover, and negative side effects from anything they gave me at a hospital. It’s a super potent option but it’s kept me home and cozy in my bed, rather than in the germs of a stressful hospital. Of course this doesn’t mean all pain should be treated this way. I know which pain is normal and which isn’t. Don’t ignore or self medicate any new pain or undiagnosed pain. Get that checked. Be safe. But if you have to treat pain issues on an ongoing basis this may be for you.
Using RSO for extreme pain can be tricky as it is super strong and if you haven’t used it before you want to be careful. I actually recommend, if this is something you are interested in trying for yourself, practice ahead of time for a couple nights. It’s an unusual substance and working with it requires a little practice and you don’t want that practice time to be when you are in a pain crisis moment. Get a handle on a dosage for you, how to administer and eliminate the fear that comes with trying something new. Recommended starting dose is about the size of a grain rice. I find the effects are much stronger for me when I am not experiencing extreme symptoms. So just try it a couple times maybe a bit before bedtime. It’ll be the best sleep of your year, you’ll see how you react to a small amount, and have a basis for where to start if you should need it for pain in an urgent situation.
You don’t want to wait until you need it to learn about what works for you. You may not need the same sized dose for your daily routine as you do in an emergency, but it’s always good to have the basics of what works for you figured out ahead of time. For me, a big dose of RSO when I’m just achy hits me hard. When Im doubled over the same amount just brings me back to normal. Such an amazing plant.
My pain management summary:
Inhaling is good for short term, daily ache and pain maintenance, but it’s effects are short in duration.
Edibles are better long term option as dosing can be consistent, they offer more of a body high which helps relieve pain, and effects can last all day.
Extreme pain situations or “flare ups” can be helped with oral consumption of RSO, which should be consumed in very small doses until your ideal dosage is determined.
All of these for me are best in an indica plant based medicine. It can cause more sedative effects but you need to sit your ass down if you want to get better so that’s okay. Hybrid, indica leaning if you must accomplish stuff that day.
I didn’t mention topicals, but they are also a great option. I love the bath bombs with thc and topical creams. So many times I have a headache and forget about topicals, but the minute I remember them and apply some to the back of my neck or temples, I get fast relief. I don’t use these on a regular basis although I find the effects amazing when I do. I honestly have no reason for always forgetting them. I think it’s an out of sight out of mind sort of thing. They are put away so I don’t think of them first. But you probably have better attention span than I do, so try those for arthritis pains, headaches and sore muscles. Be sure that you read labels as some are made for skin conditions and some are made for muscle aches. You do not want muscle rub on your rash. Trust me. So ask your favorite dispensary what they recommend but double check the label about its use, and what it is formulated to treat.
Hope that helps with the aches and pains and also those times when you need some extra.
Stay Lifted, Mama
Laura Mastropietro, former cannabis co-op grower and patient advocate, consultant, Edible Chef for two edible lines, featured in ‘Cannabis Saved my Life’ by Elizabeth Limbach, currently curates a learning hub called PotofWellness.com, stays active in the cannabis community while running a restaurant and commercial bakery in beautiful Sedona Arizona. Wife, Mother, Grandmother, with a full beautiful life and toss in a life altering disease, cannabis is the magic that helps her keep it all going. Have a cannabis question? Send it to Dear Mama at email@example.com