Accurate Education – Marijuana (Cannabis): Strains for Pain

While there are no rules, users tend to report more effective pain-relief with indica strains. In one survey, participants reported that indicas helped more than sativas when it came to headaches, joint pain, neuropathy, and spasticity. Users also reported indicas to be more helpful when it comes to sleep and sedation. While sativa-dominant strains don’t seem as popular for pain management, they  tend to have less sedative effects compared to indica strains.

However, over the several decades of widespread cannabis breeding, the ability to distinguish indica strains from sativa strains has become vague and unreliable with many hybrids now on the market. As such, it is important to evaluate the terpene profiles of individual candidate strains for pain, not just the the THC and CBD contents. While the total content and ratio of THC and CBD are major factors in pain benefit, it is largely the terpene and the minor cannabinoid profiles that distinguish one strain from another regarding a strain’s benefits and side effects.

Starting Points

THC

THC is the major contributor to pain relief associated with cannabis. Therefore most if not all strains with THC will offer at least some benefit for pain. A few key points need to be made. The dose of THC needed for pain varies significantly from individual to individual and depends on many factors, especially the individual’s tolerance based on time length of use. Few studies are available that isolate THC dosing for pain.

THC doesn’t simply work by directly reducing pain severity but instead it strongly influences the individual’s cognitive response to the pain (i.e. emotion, mood, memory etc.) to allow greater coping, relaxation and relief of pain. Therefore the other variables at play – CBD and terpenes – are very important in the ultimate response to cannabis for pain.

THC and CBD

It has been established that THC works better for pain with CBD. Recommendations for the ratio of the two are not exact but an equal amount of CBD and THC is a general starting point for pain. Higher doses of CBD, up to 8:1 or 10:1 ratios CBD:THC are recommended to reduce the side effects of THC and enhance anxiety and sleep benefits. Unfortunately, the flowers and vape products offered by LA pharmacies do not provide any CBD except for one vape product: “Freedom” by Ilera.

Terpenes

The following terpenes are most commonly recognized for their benefits for pain:

1. 1. 1. Beta-Caryophyllene
      2. Pinene
      3. Limonene
      4. Linalool
      5. Myrcene

However, the evidence for these terpenes is weak but probably best for Beta-Caryophyllene and Myrcene (especially for headaches), followed by Limonene and Linalool. Pinene and Limonene tend to be stimulating wheras Linalool and Myrcene are sedating.

Blue Dream

Harlequin is sativa-dominant but very high in CBD with less than 10% THC, so there is less brain fog and euphoria while the CBD works on pain issues. Harlequin is considered by many to be the most effective for arthritis pain and also good for fibromyalgia and nerve pain, muscle and joint pain, menstrual cramps and nausea.

Harlequin terpene profile (from industrialhempfarms.com):

alpha-Pinene (0.309%), Myrcene (0.298%), Caryophyllene (0.238%), beta-Pinene (0.099%), Humulene (0.082%), Limonene (0.058%), Linalool (0.010%), Terpinolene (<0.002%), Ocimene (<0.002%).

Total Terpenes: 1.094%

Terpene product: Harlequin Natural Terpene Blend

A sativa-dominant hybrid strain, AK-47 is a popular strains for treating chronic pain. It is reported to be derived from a variety of different strains, including South American, Mexican, and Thai sativa strains and the Afghani indica strain. While it derived from both sativa and indica, AK 47 is sativa dominant, and likely to be energizing. The terpenes in AK-47 are reported to consist mainly of Myrcene, Caryophyllene, d-Limonene, D-Alpha-Pinene, Alpha-Pinene and Beta-Pinene.

Terpene product: AK-47 Natural Terpene Blend

Jack Herer is a cross between Shiva Skunk, Northern Lights #5 and a Haze hybrid that is sativa-dominant. It originated in the Netherlands in the 1990s, Jack Herer offers analgesia but less sedation than many of the indica-based strains. The THC content of Jack Herer ranges from 18-23%, and the CBD content ranges from 0.03 -0.2%. The terpenes in Jack Herer include pinene.

Terpene product: Jack Herer Natural Terpene Blend

ACDC has mixed reports of containing high levels of CBD but low levels of THC or high levels of both. It tends to produce little to no noticeable euphoria, or “high,” suggesting that the THC content is low. It helps to relieve pain and control stress.

ACDC terpene profile (from industrialhempfarms.com):

alpha-Pinene (<0.01%), Myrcene (<0.01%), Caryophyllene (<0.01%), beta-Pinene (<0.01%), Humulene (<0.01%), Limonene (<0.01%), Linalool (<0.01%), Caryophyllene Oxide (<0.01%), , Terpinolene (<0.01%).  Total Terpenes: <0.01%

Terpene product: ACDC profile (from trueterpenes.com) with prominent alpha-Pinene and Myrcene

White Widow is a potent, balanced sativa/indica hybrid strain, blending South American sativa and South Indian indica and is widely believed to be useful for chronic pain. Emerging in the Netherlands in the 1990s, the strain gained popularity in Dutch coffee houses. Many people believe this is one of the best choices for migraine headaches and is considered very effective for sleep. Its terpene profile is reported to include nerolidol (trans-nerolidol), limonene, myrcene, linalool and caryophyllene. One source identifies the following breakdown of the terpenes in White Widow where it is notable that this breakdown does not include nerolidol (trans-nerolidol), suggesting a lack of consistency in reports of cannabis strain constituents.

White Widow terpene profile (from industrialhempfarms.com):

Linalool (3.78%), alpha-Pinene (0.521%),, Myrcene (0.43%), Caryophyllene oxide (0.30%), Humulene (0.09%.beta-Pinene (<0.01%), Limonene (<0.01%), Terpinolene (<0.01%).

Total Terpenes 5.49%

Terpene product: White Widow Natural Terpene Blend