# Studies on long-term marijuana use vs. long-term use of painkillers? **URL:** \ **Category:** Factual Questions\ **Created:** [June 9, 2005, 12:22am UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530 "2005-06-09T00:22:02Z")\ **Posts on this page:** 14\ **Page:** 1
**Author:** ![Ace309](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ace309/32/1050_2.png) [@Ace309](https://boards.straightdope.com/u/Ace309)\ **Post date:** [June 9, 2005, 12:22am UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/1 "2005-06-09T00:22:02Z")
I follow a couple of other boards, one of which in particular doesn’t hold up to the standards of debate we have here. After the SCOTUS decision on medical marijuana was handed down, a thread was opened and several posters made the bald assertion that it’s possible to exactly replicate the effects of marijuana using other prescription drugs. There have also been assertions by both sides that marijuana A) Is much better for you, you idiot, or B) Is much worse for you, you clod, than prescription painkillers. It will be useless to ask them for cites, and frankly, I don’t have a dog in the fight, so please don’t think I’m mining the SDMB for cites to slap people down. They just made me curious, and I’m wondering if anyone is aware of any empirical information that speaks to either of these topics. Thanks! ---
**Author:** ![choosybeggar](https://avatars.discourse-cdn.com/v4/letter/c/8c91f0/32.png) [@choosybeggar](https://boards.straightdope.com/u/choosybeggar)\ **Post date:** [June 9, 2005, 12:54am UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/2 "2005-06-09T00:54:06Z")
I’m no expert on the topic but went to a lecture during my internship. My understanding is that MedMJ is indicated for chronic nausea and as an appetite stimulant. I don’t recall discussion of it’s use as a pain reliever (though relief of psychic pain seems possible). The take home message was that in population-based studies, MedMJ performed no better, and in some cases worse than standard treatments for nausea and poor appetite. The lecturer also said that patients lacking prior (recreational) experience with MJ are unlikely to tolerate its “side-effects.” FTR, I’m a proponent of MedMJ and believe that you treat the individual; some patients respond better to a given therapy. ---
**Author:** ![Ace309](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ace309/32/1050_2.png) [@Ace309](https://boards.straightdope.com/u/Ace309)\ **Post date:** [June 9, 2005, 1:13am UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/3 "2005-06-09T01:13:25Z")
Thanks! I’m really unfamiliar with its use, aside from seeing a few Montel Williams episodes that are more or less pro-MJ propaganda. Any information is helpful. ---
**Author:** ![MaryEFoo](https://avatars.discourse-cdn.com/v4/letter/m/ba8739/32.png) [@MaryEFoo](https://boards.straightdope.com/u/MaryEFoo)\ **Post date:** [June 9, 2005, 1:18am UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/4 "2005-06-09T01:18:32Z")
No cite, but I’ve read that Federal law prohibits research on marijuana with very narrow exception, and so you wouldn’t expect to find (m)any proper studies for that reason. Research into the opiates is said to be less restricted. ---
**Author:** ![choosybeggar](https://avatars.discourse-cdn.com/v4/letter/c/8c91f0/32.png) [@choosybeggar](https://boards.straightdope.com/u/choosybeggar)\ **Post date:** [June 9, 2005, 4:20am UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/5 "2005-06-09T04:20:07Z")
> [@MaryEFoo](#): > > No cite, but I’ve read that Federal law prohibits research on marijuana with very narrow exception, and so you wouldn’t expect to find (m)any proper studies for that reason. > > Research into the opiates is said to be less restricted. Not too much research on the smokable varieties but THC (the main active ingredient in cannabis)is available legally with a prescription and the subject of many clinical trials. Try searching for clinical trials on PubMed using thc or cannabis as the search term. ---
**Author:** ![AskNott](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asknott/32/5790_2.png) [@AskNott](https://boards.straightdope.com/u/AskNott)\ **Post date:** [June 10, 2005, 4:20pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/6 "2005-06-10T16:20:03Z")
This is an odd Catch-22 in US law. The anti side states that no clinical trials have shown any medical value. However, since the stuff is illegal, you cannot legally get any for clinical testing. The feds actually grow a small supply for use by a handful of patients who have sued for the right to a safe supply of it. This supply is not available for research. Why? Circle back to “no clinical trials have…” ---
**Author:** ![CC](https://avatars.discourse-cdn.com/v4/letter/c/f1d935/32.png) [@CC](https://boards.straightdope.com/u/CC)\ **Post date:** [June 10, 2005, 4:56pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/7 "2005-06-10T16:56:10Z")
I question the assertion that prescription medications can replicate the effects of cannabis. For one thing, the effects are quite subjective, as this is predominantly a psycho-active drug. It may be that there are now drugs that can lower occular pressure in the same way that medical mj does for glaucoma, but the subjective effects are extrememly hard to identify, and quantify. I would be surprised if any research has been done into that aspect of any prescription drugs. What might be interesting - but not rigorous enough to be called research - would be to have people chime in with anecdotes of their experience with ANY prescription drug(s) that have caused them to feel the way that marijuana does. I’ll be waiting. xo C. ---
**Author:** ![choosybeggar](https://avatars.discourse-cdn.com/v4/letter/c/8c91f0/32.png) [@choosybeggar](https://boards.straightdope.com/u/choosybeggar)\ **Post date:** [June 10, 2005, 7:29pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/8 "2005-06-10T19:29:16Z")
> [@CC](#): > > I question the assertion that prescription medications can replicate the effects of cannabis. For one thing, the effects are quite subjective, as this is predominantly a psycho-active drug. It may be that there are now drugs that can lower occular pressure in the same way that medical mj does for glaucoma, but the subjective effects are extrememly hard to identify, and quantify. I would be surprised if any research has been done into that aspect of any prescription drugs. What might be interesting - but not rigorous enough to be called research - would be to have people chime in with anecdotes of their experience with ANY prescription drug(s) that have caused them to feel the way that marijuana does. I’ll be waiting. xo C. [Point](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12073159&query_hl=3) > [@](#): > > **Comparison of the subjective effects of Delta(9)-tetrahydrocannabinol and marijuana in humans.** > RATIONALE: There has been controversy about whether the subjective, behavioral or therapeutic effects of whole plant marijuana differ from the effects of its primary active ingredient, Delta(9)-tetrahydrocannabinol (THC). However, few studies have directly compared the effects of marijuana and THC using matched doses administered either by the smoked or the oral form.OBJECTIVE: Two studies were conducted to compare the subjective effects of pure THC to whole-plant marijuana containing an equivalent amount of THC in normal healthy volunteers. In one study the drugs were administered orally and in the other they were administered by smoking.METHODS: In each study, marijuana users (oral study: n=12, smoking study: n=13) participated in a double-blind, crossover design with five experimental conditions: a low and a high dose of THC-only, a low and a high dose of whole-plant marijuana, and placebo. In the oral study, the drugs were administered in brownies, in the smoking study the drugs were smoked. Dependent measures included the Addiction Research Center Inventory, the Profile of Mood States, visual analog items, vital signs, and plasma levels of THC and 11-nor-9-carboxy-THC.RESULTS: In both studies, the active drug conditions resulted in dose-dependent increases in plasma THC levels, and the levels of THC were similar in THC-only and marijuana conditions (except that at the higher oral dose THC-only produced slightly higher levels than marijuana). In both the oral study and the smoking study, THC-only and whole plant marijuana produced similar subjective effects, with only minor differences.CONCLUSION: These results support the idea that the psychoactive effects of marijuana in healthy volunteers are due primarily to THC. [Counterpoint](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12491031) > [@](#): > > In response to your recent publication comparing > subjective effects of D9-tetrahydrocannabinol and herbal > cannabis (Wachtel et al. 2002), a number of comments are > necessary. The first concerns the suitability of the chosen > “marijuana” to assay the issues at hand. NIDA cannabis > has been previously characterized in a number of studies > (Chait and Pierri 1989; Russo et al. 2002), as a crude lowgrade > product (2–4% THC) containing leaves, stems and > seeds, often 3 or more years old after processing, with a > stale odor lacking in terpenoids. This contrasts with the > more customary clinical cannabis employed by patients in > Europe and North America, composed solely of unseeded > flowering tops with a potency of up to 20% THC. > …Finally, although anecdotal, this author (E.B.R.) has > had the opportunity to interview an estimated 200 patients > who have employed Marinol and clinical cannabis, > whether smoked or ingested. In no instance were the > effects of the former considered of equal efficacy to > cannabis, but rather more productive of dysphoric and > sedative adverse effects (Calhoun et al. 1998). > In essence, clinical cannabis demonstrates herbal > synergy and is more than a simply a vehicle for THC > administration. I don’t know what these guys are smoking 😃 Of note, THC is legally distributed with a prescription in the USA. The tradename is [marinol](http://www.marinol.com/) ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [June 10, 2005, 7:50pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/9 "2005-06-10T19:50:32Z")
> [@](#): > > several posters made the bald assertion that it’s possible to exactly replicate the effects of marijuana using other prescription drugs. Bull. Cannabinoids have their own receptors. For other drugs to have the exact same effects, they’d have to bind to those receptors. > [@](#): > > In 1988, specific receptors were discovered for THC (tetrahydrocannibol, the active ingredient in marijuana). > > THC isn’t found naturally in the body. The existence of a specific ‘bliss receptor’ for THC implied that it was actually just a forgery of a hitherto unknown natural molecular key. The key was isolated by Israeli scientist Raphael Mechoulam in 1992: arachidonyl ethanolamide, later called ‘anandamide’ [Anandamide](http://antoine.frostburg.edu/chem/senese/101/features/anandamide.shtml) > [@](#): > > To date, two cannabinoid receptors have been identified. The first receptor (CB1) is found largely in the brain [L. Matsuda et al. Nature. 246, 561-564, 1990. C.M. Gerard et al. Biochem. J. 279, 129-134, 1991.] The second cannabinoid receptor (CB2) is found largely in the periphery. [S. Munro, K.L. Thomas, M. Abu-Shaar Nature, 365, 61-65, 1993.] Both receptors are G-protein-coupled receptors. [Cannabinoid Receptors](http://science.kennesaw.edu/projects/cab/rinfo.htm) ---
**Author:** ![Ace309](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ace309/32/1050_2.png) [@Ace309](https://boards.straightdope.com/u/Ace309)\ **Post date:** [June 10, 2005, 8:25pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/10 "2005-06-10T20:25:23Z")
Thanks, guys. This has been enlightening. ---
**Author:** ![CC](https://avatars.discourse-cdn.com/v4/letter/c/f1d935/32.png) [@CC](https://boards.straightdope.com/u/CC)\ **Post date:** [June 10, 2005, 9:27pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/11 "2005-06-10T21:27:19Z")
…although the question hasn’t been answered, yet. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [June 10, 2005, 9:40pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/12 "2005-06-10T21:40:56Z")
> [@CC](#): > > …although the question hasn’t been answered, yet. To do that, someone would have to do the research. Who knows, maybe the Brits or the Canadians are looking into it. It’s not going to happen in te US. ---
**Author:** ![choosybeggar](https://avatars.discourse-cdn.com/v4/letter/c/8c91f0/32.png) [@choosybeggar](https://boards.straightdope.com/u/choosybeggar)\ **Post date:** [June 10, 2005, 10:02pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/13 "2005-06-10T22:02:20Z")
> [@CC](#): > > …although the question hasn’t been answered, yet. It’s hard to say about long-term use, hard to say what whole plant extracts may offer compared with pure THC, but it is clear that THC is not as effective an analgesic as narcotics (in some cases subjects report increased pain). [Reference](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14499423&query_hl=8) > [@](#): > > From folk medicine and anecdotal reports it is known that Cannabis may reduce pain. In animal studies it has been shown that delta-9-tetrahydrocannabinol (THC) has antinociceptive effects or potentiates the antinociceptive effect of morphine. The aim of this study was to measure the analgesic effect of THC, morphine, and a THC-morphine combination (THC-morphine) in humans using experimental pain models. THC (20 mg), morphine (30 mg), THC-morphine (20 mg THC+30 mg morphine), or placebo were given orally and as single doses. Twelve healthy volunteers were included in the randomized, placebo-controlled, double-blinded, crossover study. The experimental pain tests (order randomized) were heat, cold, pressure, single and repeated transcutaneous electrical stimulation. Additionally, reaction time, side-effects (visual analog scales), and vital functions were monitored. For the pharmacokinetic profiling, blood samples were collected. **THC did not significantly reduce pain. In the cold and heat tests it even produced hyperalgesia, which was completely neutralized by THC-morphine.** A slight additive analgesic effect could be observed for THC-morphine in the electrical stimulation test. No analgesic effect resulted in the pressure and heat test, neither with THC nor THC-morphine. Psychotropic and somatic side-effects (sleepiness, euphoria, anxiety, confusion, nausea, dizziness, etc.) were common, but usually mild. Bolding mine ---
**Author:** ![irishgirl](https://avatars.discourse-cdn.com/v4/letter/i/8edcca/32.png) [@irishgirl](https://boards.straightdope.com/u/irishgirl)\ **Post date:** [June 10, 2005, 10:03pm UTC](https://boards.straightdope.com/t/studies-on-long-term-marijuana-use-vs-long-term-use-of-painkillers/307530/14 "2005-06-10T22:03:57Z")
I think the nearest answer to a correct one is going to be that for some people Cannabis will work very well, and they’ll choose it in preference over other therapies, for some it will not relieve any of the symptoms it’s supposed to and for yet others it will work up to a point, but they will prefer their standard therapies. Not everyone reacts to drugs in the same way, not everyone tolerates side effects in the same way and not everyone thinks being stoned is a negative side effect! If some people find it works for them, and they tolerate the side effects better than their standard medication, well, they should use it. People who don’t get benefit from it, or don’t like the way it makes them feel, well they can use something else. It doesn’t necessarily have to be an all-or-nothing, black or white answer.