A New Frontier in Pain Relief: Terpenes and CBD
The opioid crisis is a national concern in the United States and a global issue, with millions of people suffering from chronic pain and seeking effective treatments that do not carry the risks associated with opioids. In 2019, the National Health Interview Survey reported that 22.1% of American adults with chronic pain had taken prescription opioids within the last 3 months.1 There are many barriers to addressing this crisis, including the stigma surrounding addiction, limited access to non-opioid pain management options, and a lack of understanding of the complex mechanisms involved in pain perception and relief.
However, one potential solution may lie in compounds found in Cannabis. Cannabis contains many chemical compounds, including cannabinoids, terpenes, and flavonoids. The main active compounds in Cannabis are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is responsible for the psychoactive effects of Cannabis, while CBD has potential therapeutic benefits without the "high" associated with THC. Terpenes make up 1-2% of Cannabis and are responsible for each strain's unique smells and flavors.
Research has shown that both THC and CBD can help relieve pain. However, terpenes also may possess analgesic properties and can interact with THC and CBD to enhance their pain-relieving effects. This synergy is known as the "entourage effect," where the effect of the whole plant is more than each of its parts individually. To understand the entourage effect, think of THC and CBD as lead singers and terpenes as the band. The lead singers sound great on their own, but the band amplifies their voices and creates the music.
Cannabis has been used for centuries to treat pain, and with further research into the specific terpenes found inside, we may be able to develop more targeted and efficient treatments for chronic pain. This is the work that I’m pursuing. One terpene, beta-myrcene, is commonly found in Cannabis as well as mangoes and has been shown to have anti-inflammatory and analgesic properties. Another terpene called beta-caryophyllene is found in hops and acts on the body's endocannabinoid system, which plays a role in pain sensation and inflammation. Linalool is commonly found in lavender and is known for its calming and relaxing properties. In a 2018 study, researchers found that it could prevent inflammation induction.2 The last terpene that I am researching is alpha-pinene which is found in pine trees and has been shown to also have anti-inflammatory effects.
By reducing the dependence on opioids and harnessing the power of terpenes, we can help address the opioid crisis and provide patients with safer and more effective pain management options. However, it's important to note that Cannabis-based treatments are not without their own risks and side effects, and further research is needed to fully understand their potential benefits and drawbacks.
References
1. Dahlhamer JM, Connor EM, Bose J, Lucas JL, Zelaya CE. Prescription Opioid Use Among Adults With Chronic Pain: United States, 2019. Natl Health Stat Report. 2021 Aug;(162):1-9. PMID: 34524076.
2. Lee SC, Wang SY, Li CC, Liu CT. Anti-inflammatory effect of cinnamaldehyde and linalool from the leaf essential oil of Cinnamomum osmophloeum Kanehira in endotoxin-induced mice. J Food Drug Anal. 2018 Jan;26(1):211-220. doi: 10.1016/j.jfda.2017.03.006. Epub 2017 Apr 19. PMID: 29389558; PMCID: PMC9332676.
Kaylin Ellioff is a Pharmacology graduate student at the University of Washington, where she studies different chemicals found in cannabis and how they can be used to treat chronic pain.