Marijuana vs. Opioids: Which is More Effective for Treating Pain?

With 115 people dying from opioid overdoses every day, it’s about time to find an alternative to opioid painkillers. Unfortunately, most alternatives fall short in terms of their pain-killing abilities.

Recent research shines the spotlight on one alternative that may have a chance to make a dent in America’s addiction epidemic.

Can cannabis effectively treat pain?


The short answer to this question seems to be yes. In fact, cannabis is already being used to treat chronic pain in states where it is legal. We’ve seen a staggering 64 percent decrease in opioid use in those states, according to a 2016 study published in the Journal of Pain. Most notable, though, was the decrease in unwanted side effects that study participants experienced. There’s a vast difference in the side effects of marijuana versus opioid painkillers.

A systematic review published in Therapeutics and Clinical Risk Management concludes that cannabinoids are generally well tolerated by cancer patients and shows great promise as a treatment for pain.

And last but not least, the first and largest study done on the long-term safety of medical cannabis for chronic pain shows that daily cannabis users experienced significant improvement in their pain levels, symptom distress, mood and quality of life compared to participants who did not consume cannabis. Also, the cannabis users had no greater risk than non-users for serious adverse effects. The study, published in the Journal of Pain, found that patients didn’t experience any harmful effects on cognitive function or blood tests.

Cannabis is the Patient’s Choice

When you know something is as harmful as opioid painkillers can be, you’d likely be more satisfied with any alternative that works.

The problem with a lot of opioid alternatives is that they don’t work nearly as well as opioids. We can’t say that cannabis is as effective, but it may be in the same realm.

Even if it is not quite as effective, it may be helpful as an adjunct to pain therapy. A study in Cannabis and Cannabinoid Research investigated whether patients prefer opioids or medical marijuana for pain relief and found that patients preferred marijuana. Many of the patients also noted that medical marijuana is just as effective for pain as the opioids.  

Some of the study participants were able to cut back on opioid use when they added medical marijuana to their pain treatment protocol, which resulted in fewer unwanted side effects than they were seeing with opioids alone.

How Marijuana Relieves Pain

If you’re new to the realm of medical marijuana, you may be wondering how cannabis can treat so many conditions that are seemingly unrelated. It’s a common question and likely the reason so many people doubt the efficacy of medical marijuana.

And although we may not yet know everything about how marijuana works in the body, there is some science behind its pain-relieving abilities.

Interestingly enough, marijuana and opioids are both analgesics that block pain signals in the brain and central nervous system. Both marijuana and cannabis block pain by binding to receptors in the brain. That’s where the similarities end, though.

To find out exactly how marijuana blocks pain, Oxford researchers studied a group of healthy participants using doses of THC and an MRI machine. What they found was somewhat surprising. According to the Oxford researchers, marijuana doesn’t kill pain as much as it makes it more bearable. Brain images from the study showed that patients dosed with THC experienced about the same level of pain as their non-THC counterparts, but they didn’t feel it as much.

Researchers concluded that THC affects the emotional reaction to pain and not the pain itself. They also found that reactions were highly variable. So, THC may work better as a pain reliever for some people than others.

The Bottom Line

There’s enough research to conclude that medical marijuana may be a suitable alternative to opioids, but of course more research must be done. In the meantime, given the comparative risks, it seems safer to try medical marijuana before turning to opioids, if you live in a state where this is legal.