Chronic pain (pain that affects an individual for over 12 weeks despite treatment) is experienced by a fifth of the UK population. As patients suffer, so too does the wider population with pain costing the UK economy £23 billion a year – more than both cancer and cardiovascular disease. Furthermore, the elderly make up the greatest proportion of chronic pain patients meaning the disease burden is set to increase with the number of people over 60 doubling by 2050.
Currently, opioids are the standard treatment for many chronic pain conditions. Opioids work as powerful painkillers by binding to specific neurone receptors, inhibiting their ability to transmit pain signals. This results in significantly (if not completely) attenuated perception of pain by the patient. However, opioid receptors are also present in the brain and when bound to, release dopamine. Dopamine is a neurotransmitter that promotes the desirability of an outcome, i.e. an action that results in dopamine release causes a strong positive association in the brain, regardless of other potentially deleterious effects. This is what causes the extreme addictive nature of opiate products. Over time individuals develop tolerance to opioids, reducing their effectiveness as painkillers and the drug’s ability to elicit dopamine release. This causes people to seek ever higher doses. It is this that has resulted in the opioid epidemics seen amongst populations to which they are prescribed.
Fortunately, there may be an alternative. Studies and a wealth of patients attest to the analgesic properties of cannabis. There are over 100 phytocannabinoids in cannabis plants of which 60 are known to be pharmacologically active. Of these, THC and CBD are the most comprehensively understood. THC and CBD bind to different cannabinoid receptors, but both address several chronic pain conditions such as fibromyalgia, endometriosis and cancer pain (amongst others). Research is ongoing to ascertain the direct action of different cannabinoids to better tailor treatment for specific conditions. Despite this, numerous patients have been able to dramatically improve their quality of life following medical cannabis prescriptions.
Cannabis medication does not possess the extreme potency of many opiate drugs and research suggests that cannabis works best when treatment is tailored to a specific pain causing condition. As such, medicinal cannabis is not a panacea for the opioid crisis, yet it acts as a viable alternative for many patients experiencing a broad range of chronic pain conditions and has been associated with reduced opioid use. Indeed, opioid associated hospital admissions and prescriptions are reduced in US states in which cannabis is legal.
Óskare Capital strongly believes in the therapeutic potential of medicinal cannabis in chronic pain conditions. That is why we have recently invested in Cellen, a UK based company operating the Leva Clinic, a telehealth service providing personalised treatment for chronic pain conditions. Their targeted pain management solutions go beyond just medication, adopting a 360º approach to patient wellbeing. Leva’s treatments, prescribed by world-leading specialists, allow patients to live more and hurt less.