By Whitney Deatherage Cannabis Coach and Educator

I could say my story of chronic pain began at the beginning of 2014, but I’ve learned to go back and look for clues from earlier in life. Multiple childhood sports injuries, frequent recurring illnesses, falling all the time, and a near-fatal car accident in my early twenties - to me, these were unconnected incidents. It wasn’t until a mysterious abdominal pain showed up in 2014 that one doctor connected the dots: Chronic pain exacerbated by chronic illness. We would be here all day if I listed all the specifics of my ailments because, like many chronic pain sufferers, there is no single thing to point to, blame, or “fix.” I tried every type of medication and treatment available to me at the time. This ordeal continued until 2016 when my GP sent me to a Chronic Pain Doctor who told me about an outpatient program for Chronic Pain Management. It required me to go on disability temporarily, which led to a lot of shame and guilt for not being productive. I lost count of the times I heard, “But you’re not REALLY disabled…”

I signed up and gave my life to the program, which they modeled after the Mindfullness-Based Stress Reduction Program designed by Jon Kabat-Zinn for Johns Hopkins. I had a team of specialists I saw four times a week, did group and individual therapy, tried different types of conscious movement, tried a variety of mindfulness practices, and I learned to slow down. More importantly, I learned how to love all of myself, including the parts that hurt. 

Then the pandemic came, and I took it as another opportunity to slow down. The world was different, and I was different, and I didn’t want to go back to the work I was doing before lockdowns began. One of my lockdown hobbies was making Cannabis salve for myself and my family. Because some relatives were too nervous about using ANYTHING with Cannabis, I wanted to find a good source of information about how topicals can work without making the user intoxicated. I had been using Cannabis topicals and edibles with decent success, but as I began researching more about the Endocannabinoid System (ECS) I wondered if I could do better.  After going down many internet rabbit holes, I found the blog Wake and Bake, which led me to discover the Cannabis Coaching Institute (CCI). I knew immediately that this was what I wanted to do. 

Before classes started, CCI had some activities on social media, and that’s where I first connected with Caress. We bonded immediately, and when it was time to choose a coaching partner for the program, we picked each other. It must have been fate because we have similar health backgrounds, similar reasons for choosing Cannabis as medicine, and similar ways of managing our chronic pain. During our mutual coaching sessions, we discovered that we both have a selection of practices and tools that we rely on during pain flare-ups and daily practices to keep the flare-ups at bay. This is how the concept of The Chronic Toolkit emerged. 

What is Chronic Pain? 

Chronic pain is pain that lasts longer than three months, regardless of treatment. Causes can include neurological damage after illness or injury, or from an ongoing health problem like cancer, arthritis, or autoimmune disease. In many cases there is no known cause, and there is no universal method of treatment. This two-minute video is a great way to share the concept of chronic pain with your friends and family.

Why Mindfullness Matters:

The term mindfulness has become so commonplace in the wellness industry that it’s easy to forget why it matters. It can be frustrating to hear that chronic pain is caused by the brain, but that’s different than saying it’s all in your head. Chronic pain is a negative feedback loop between the brain and nervous system, and it is possible to use your brain to end the cycle, or at least slow it down. Will  mindfulness techniques cure you or take away the pain? Of course not. What they can do is help you not suffer quite so much. This page from The Center for Healthy Minds at the University of Wisconsin explains the process of using modern scientific methods to measure something as variable as “well-being.” 

What Can Be Done for Chronic Pain? 

I had to learn the hard way that the first step in managing chronic pain has to be acceptance. I didn’t want to accept it. I wanted to fight it and I wanted to win. It took some time to see that I was fighting against reality. I had pain that could not be helped by any medication or procedure. It was up to me to learn how to live with it. I had to give up the idea of ever being “all better,” but I knew I could at least be better than I was. Acceptance is not an easy route, and people close to you may be upset. Remember that acceptance is not giving up. It’s not complacency. You don’t have to like it. Acceptance is what will give you the opportunity to find the parts of your life that you can do something about. 

A few words about self-care...

• Self-care is not always relaxing. Sometimes self-care is taking care of a task you’ve been putting off.
• Self-care can be sitting down and making a household budget - not an easy task but one that can ease stress over time.
• Self-care can be having that difficult conversation you’ve been avoiding - getting it over with can prevent it from keeping you up at night.
• Self-care is also a luxury - sometimes just the luxury of time. A breathing exercise costs nothing and may only take a minute, but it carries the greater mental load of remembering to do it.
• Self-care is a PRACTICE. You’re not going to be “good at” meditating right away  - it’s a skill you need to learn. Fortunately, you still benefit from the practice.

Not all these methods will apply or appeal to everyone - use them as a launching point. Find the parts that appeal to you the most and work them into your life in a way that makes sense to you. Even if you only do a tiny bit, that is more than you did yesterday. Don’t worry about making too many adjustments all at once. Find things that bring you comfort and incorporate them gradually into your routine. 

What’s in your toolkit? 

An item in your toolkit could be a physical object, like a Cannabis salve, a massage tool, or a soft blanket. Some will be conceptual tools - a daily habit or a distracting activity. For the conceptual tools, it can be helpful to have a physical reminder like a list (paper or digital) of your favorite distracting activities to refer to when pain flares up. Set reminders on your calendar for your daily stretches or breathing exercises. 

Some examples -

(see more examples at chronictoolkit.com)

Cannabis for Chronic Pain

Whichever method you choose, start with low doses and slowly add more until you find the right dose for your needs. Add in one product at a time to get a clear idea of what it does for you. I can’t stress the following enough - track your intake and results daily. You don’t have to do this forever, but track while finding your ideal dose and whenever you make adjustments down the line. There is a fair amount of trial and error to finding your ideal dose, and tracking is the best way to take the guesswork out of it. There are apps and journals dedicated to cannabis intake and symptom tracking, or you can create your own on paper or with a spreadsheet. Tracking forces you to pay attention to what’s happening in your body on a regualr basis, and can help you learn to make the best choices based on what your body needs, day-to-day and moment-to-moment.

Consumption Methods and Tips:

-Salve and topicals - 

These can be a great way to introduce your body to Cannabis without the intoxicating effects. They are typically sold as lotions, ointments, bath salts, and roll-ons. Many people find relief with topicals for issues like joint pain, restless leg syndrome, muscle aches and tension, cramps, and a variety of skin irritations like eczema and psoriasis. 

Some things to remember with topicals:

• Unless they are specifically labeled as “transdermal,” they will *not* enter the bloodstream and will not make you high. Some people report a relaxed feeling in the body, but if it’s not entering your blood, it’s not entering your brain. Transdermal formulas contain added ingredients to allow the Cannabinoids to enter the bloodstream through the skin and will be labeled as such. 
•  Start with a small amount of ointment/lotion and take a moment to rub it in well. If you can do it after a hot bath or shower, or apply heat afterward, even better. 
• Your body builds more receptors in the areas where you apply topicals. The more you use them, the better they work!

-Suppositories-

They will not get into your system the way edibles do and are typically only good for issues in the local area. Think of Cannabis or CBD suppositories as a topical for the inside of your torso areas. (Lower back pain, menstrual, pelvic floor, hip or S/I joint pain, and some intestinal issues, etc.) 

-Edibles- 

Cannabis edibles are often in candy forms like chocolate or gummies, though sometimes you can find other infused snacks or beverages. Some people prefer tablets or capsules to swallow. The right dose is different for everybody, but many chronic pain patients find that a minimal amount taken daily is more effective than taking large amounts only during flare-ups. Edibles tend to deliver a deeper body effect than smoking can, making this a great way to treat pain. 

-Inhaling - 

Medically speaking, the safest way to inhale Cannabis is with a dry herb vaporizer. Some people prefer the convenience of vaporizing concentrates, and in these cases, it's best to select solventless, full-spectrum, additive-free options. Whichever method you choose, inhaling Cannabis is an excellent option for quick relief from breakthrough pain.  

-Tinctures/sublinguals - 

These usually have a faster onset than edibles, but not quite as fast as inhaling. Like an edible, you can swallow these to get a deeper body high. You can also hold them under your tongue, swish them, or gargle them to get them into your bloodstream. Some companies make sublingual tablets and strips to dissolve under the tongue. 

A Word About Alternative Cannabinoids - 

While there still isn’t a lot of data on the rarer and acidic Cannabinoids, early research shows that some of them (CBDA, CBC, CBG, etc.) can be beneficial for things like pain and inflammation without intoxication. 
(More details on alternative cannabinoids and correlating studies.)

Your Keys to Success

There are many different ways to use Cannabis for pain relief, and it can be overwhelming. Remember these three key points:

1. Start slow and low - Whatever your choice of delivery method is, start with a very small dose (like one puff from a vape pen) and wait an hour before increasing the dosage. Pay attention to how you feel as you go up in dosage, if you find relief at a certain point- that’s your sweet spot!

2. Find what works for you - Everyone reacts differently to Cannabis, so experiment until you discover what works best for you and stick with that. Also keep in mind that although some people respond well to specific Cannabinoids or ratios, others are more sensitive and might need to try different combinations.

3. Listen to your body - You know yourself better than anyone else, so don’t hesitate to adjust your dose if you feel like something isn’t working. Keep an eye out for any unpleasant side effects and stop using the product if they become too uncomfortable.

Remember, there is no one-size-fits all solution when it comes to Cannabis and pain relief - everyone is different and it’s important to be patient while finding what works best for you! 

We hope this article has given you a better understanding of the different ways to use Cannabis for pain relief and other medical conditions. Whether it be topicals, suppositories, edibles, inhaling or tinctures/sublinguals - there are many options available that can provide relief without getting high. Remember to start small if trying something new and always consult with an informed healthcare professional before starting any kind of cannabis regimen. Good luck on your journey towards healing!

A note about intoxication - I speak a lot about using Cannabis without intoxication because that is a common request for people who want to experience the benefits of Cannabis all day long and still be able to keep their brains. Some people wait until the evening to add THC, and some want to avoid it altogether. It is absolutely not a judgment on intoxication. Intoxication is not inherently wrong, and Cannabis users aren’t bad people because their medicine may intoxicate them. 

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Main takeaways: 

How small daily rituals can help prevent pain flare-ups & how to create personalized daily rituals
• How to get a toolkit ready for when flare-ups do occur
• Incorporating Cannabis into your toolkit

About Whitney Deatherage:

Whitney is a Certified Cannabis Coach and Educator. You can join the waitlist to learn more about the Chronic Pain Toolkit at chronictoolkit.com. You can also click the learn more button to be routed to her business website Practical Elevation.

Effective Cannabis Newsletter is a platform to educate on the vital role of the Endocannabinoid System (ECS) in one's health. The information is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. All content, including text, graphics, images, and information, contained in or available through this newsletter is for general information purposes only. It is not medical advice; it is health awareness.