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Cannabis and Chronic Pain

Cannabis and Chronic Pain

If an alien came down from space and asked you to define “pain,” how would you respond? We’ve all had it. We know it’s awful. But, defining it is another story. How do you define a highly subjective experience? Those who live with pain on a near daily basis will likely describe it as “debilitating,” “exhausting,” and “intolerable.” Describing it easy, but defining it is more difficult. The International Association for the Study of Pain (IASP) offers a useful definition: “[Chronic pain] is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

20 percent of American adults report suffering from chronic pain, a staggering number that is only expected to increase over coming years. As science advances, it may seem incomprehensible that more people will suffer from chronic pain in the future than they do now. But, paradoxically, as science advances, people live longer and survive conditions that previously would have ended their lives. Conditions such as cancer, severe injuries, HIV, that were once a death sentence are now treatable. And, while the patients survive, they’re often left to deal with severe persistent neuropathic pain.

Legal medical marijuana is available to more than half of America. Given how widespread chronic pain is and how limited truly efficacious treatment options are, predictably, an increasing number of sufferers are turning to cannabis to treat their condition.

However, whether cannabis is right for you is a highly personal decision. What works for others, may not be appropriate for your situation. Likewise, deciding on whether cannabis should be an adjunctive therapy to your your current treatment protocol or a replacement, is yet another consideration.

We have accumulated more evidence supporting a therapeutic role for cannabis to treat chronic pain than we have for most other conditions. Nonetheless, before you decide to use cannabis, it’s important you develop a fundamental understanding of the dynamics of chronic pain, and how cannabis may (or may not) fit into your treatment program.

What is Chronic Pain?

Broadly speaking, if you have pain that has persists for more than three months and has not been relieved by medical or surgical care, you may have a chronic pain condition. Chronic pain is a condition characterized by generalized muscle or nerve pain, that persists well beyond reasonable expectations of recovery; it affects 100 million Americans — approximately two out of five adults.  

Nociceptive - Caused by tissue damage or inflammation, it is usually described usually described as sharp, aching, or throbbing pain.  

Neuropathic - Caused by nervous system damage or malfunction. Sufferers commonly describe the pain as causing numbness or a burning sensation.

Conditions and Diseases Associated with Chronic Pain:

  • Fibromyalgia
  • Rheumatoid arthritis
  • HIV/AIDS
  • Cancer
  • Spinal diseases
  • Complex regional pain syndrome (CRPS)
  • Recurrent headache, including migraines
  • Painful neurological disorders resulting from damage to the nerves

Issues Commonly Caused by Chronic Pain:

  • Immobility, followed by wasting of muscle and  joints
  • Health issues from immune system issues that can cause increased vulnerability to disease
  • Insomnia and sleep disturbances
  • Depressed appetite and poor diet
  • Dependence on medications.
  • Job performance issues
  • Isolation from friends and family
  • Fear and anxiety
  • Depression which can become severe leading to a higher risk of suicide

What Causes Chronic Pain?

Anyone can develop chronic pain, although it most commonly affects older adults and people with health conditions like diabetes, arthritis, or back problems. There are also a number of specific diseases that associated with chronic pain, including shingles, diabetes, blood vessel problems, HIV, and most types of cancer. While treatment may cure one of these diseases, it’s common for chronic pain symptoms to persist.

Treatment may bring the disease under control, or even cure it completely, but the chronic pain persists. Similarly, in the event a pain-inducing disease may not be able to be cured, does not mean the pain cannot be mitigated. Effective pain management requires ongoing attention in conjunction with a qualified medical professional.

What Treatments Are Available to Treat Chronic Pain?

  • Antidepressants
  • Anticonvulsant analgesic
  • Nonsteroidal
  • Anti-inflammatory drugs
  • Opioids

The downside of these treatments is that for many patients they are only nominally effective and can come with intolerable and potentially debilitating side effects, including:

  • Constipation with opioids
  • Gastrointestinal issues
  • Cardiovascular damage from NSAIDs

Because of the unpredictable efficacy, often intolerable side effects, and risk of addiction, an increasing number of patients are turning to cannabis.

How Does Cannabis Treat Chronic Pain?

The endocannabinoid system (ECS) is responsible for a number of physiological functions related to health, including pain modulation and inflammation. The ECS, through two receptors, CB1 and CB2, help modulate a variety of functions, including:

CB1: Appetite, muscle control, pain, cognition, and reward

CB2: Immune function, cell proliferation, inflammation, and pain

When you ingest cannabis, cannabinoids such as THC and CBD, act on the endocannabinoid system’s receptors and periphery to provide anti-inflammatory and analgesic effects.

“I believe that the reason we and all animal species have the complex system of cannabinoid receptors and endocannabinoids is to help us modulate the experience of pain,” notes Dr. Donald Abrams, professor of clinical medicine at the University of California, San Francisco and chief of hematology & oncology at San Francisco General Hospital. “It is no wonder, therefore, that the plant cannabinoids also seem to have a significant analgesic activity.”

How Effective Are Cannabinoids in Treating Chronic Pain?

Over 200 studies have been conducted evaluating the efficacy of cannabis and cannabinoid-derived formulations to treat chronic pain conditions. One comprehensive systematic study conducted by Harvard professor and addiction psychiatrist, Dr. Kevin Hill, reviewed 28 well-designed studies. The author concluded, “[The] use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence.”

Summary of Key Findings:

  • Six out of six general chronic pain studies demonstrated significant improvement in symptoms.
  • Five out of five neuropathic pain studies found a significant improvement in symptoms. (Three out of five studies investigated “smoked” cannabis, while two examined an oral spray preparation).

Canadian researchers came to similar conclusions in their 2011 Review Study of 18 trials, identifying 15 trials that demonstrated efficacy in treating chronic non-cancer pain. They noted several trials reported significant improvements in sleep, with no serious side effects. Further, the studies found just a few adverse effects which were mild to moderate and well tolerated.  

Can Cannabis Help Patients Eliminate (Or Reduce) Opioids?

In recent years, North America has been ravaged by an ever-growing epidemic: opioids. Since Purdue Pharma brought OxyContin to the market in the mid 1990s, prescriptions have increased four-fold. Following the increase in prescriptions, rates of heroin addiction and the number of opioid-related overdoses have skyrocketed.

Data from the Centers for Disease Control (CDC) illustrate how dire the situation is:

  • Fatal overdoses have increased by 400%: sales and overdoses of prescription opioids quadrupled between 1999 and 2014.
  • More than 165,000 people have died in the U.S. from overdoses related to prescription opioids between 1999 and 2014
  • At least half of all U.S. opioid overdose deaths involve a prescription opioid.
  • More than 14,000 people died from overdoses involving prescription opioids in 2014.

Evidence suggests opioids are only effective for acute pain, and many patients find they must progressively increase their dosage to achieve the same effect; within a short period of time, their pain isn’t responsive to opioid treatment.

How could medical marijuana help? By providing an efficacious substitute to opioids, or helping patients reduce their opioid intake. The Centers for Disease Control argue that the overprescribing of opioid is fueling the epidemic, so it would be a sensible strategy to encourage physicians to consider cannabis as an alternative (or, adjunct) to opioid-based treatment programs.

Cannabis Acts Synergistically With Opioids

There is evidence that cannabis (or, more specifically, cannabinoids) may act synergistically with opioids, allowing patients to lower dosage of opioids while achieving comparable pain relief.

Dr. Abrams conducted a small study to investigate cannabis as an opioid potentiator. His team found that while vaporized cannabis didn’t affect morphine or oxycodone blood levels, patients reported (on average) a 27% decrease in pain. By augmenting “the analgesic effects of opioids without significantly altering plasma opioid levels,” Abrams and his team concluded vaporized cannabis produces a “synergistic effect.”

“We have studied the effectiveness of cannabis in painful nerve damage (neuropathy) as well as in combination with opiates. From my own oncology practice I am impressed that cancer patients are able to decrease their use of narcotic analgesics when adding in cannabis medicines.” — Dr. Abrams

Dr. Mike Hart, Head Physician at Marijuana for Trauma (Ontario, Canada), agrees: “In my clinical practice I frequently work with patients who are able to significantly reduce their dependence on opioids,” said Dr. Hart. “In hundreds of cases, I’ve seen patients who’ve been able to wean off them altogether by integrating cannabis into their treatment protocol.”

Cannabis Can Reduce Opioid Use

Studies support the role of cannabis as part of a strategy to reduce opioid use. A University of Michigan March 2016 Study provided evidence that cannabis may be superior to opioids and provide a valuable harm reduction strategy.

Cannabis use by chronic pain patients was associated with the following outcomes:

  • Decrease in Opioid Use: 64% lower opioid use
  • Quality of Life: Cannabis use associated with improved quality of life
  • Reduces Side Effects: Reduction in side effects from other medications

The authors also noted that previous studies found that when states enacted medical marijuana laws, they went on to experience (on average) a 25% decline in fatal opioid overdoses.

Dr. Daniel Clauw, one of the study’s researchers and a professor of pain management anesthesiology at the University of Michigan Medical School, commented: "We are learning that the higher the dose of opioids people are taking, the higher the risk of death from overdose. This magnitude of reduction in our study is significant enough to affect an individual's risk of accidental death from overdose."

“Cannabis can play an important role in pain relief — with or without opiates — and, given the epidemic level of opioid overdoses, clearly more physicians should seriously consider cannabis as part of their patients’ therapeutic protocol. Not to, would be irresponsible, if not unethical.” — Dr. Michael Hart, Marijuana for Trauma

Case Study: Kevin Ameling, A Real World Success Story

A “real-world” success story comes from Kevin Ameling, a chronic pain patient who now works for the IMPACT Network in Colorado (a cannabis research advocacy non-profit), is a success story. After getting injured from a fall in 2007, his doctor prescribed him a combination of prescription drugs that included Clonazepam, Tramadol, Lexapro, and OxyContin.

As his chronic pain progressed, Ameling had found the drugs to be less effective, particularly the OxyContin. A resident of Colorado, he became a medical marijuana patient. Cannabis helped him reduce reliance on on prescription drugs, allowing him to cut his dosages significantly:

  • Clonazepam: 3 mg to .5mg
  • Lexapro: 30 mg to 5 mg
  • Tramadol: 300 mg to 75 mg
  • OxyContin: Reduced daily intake by more than 50% (and, reports being able to skip doses)

“I was well aware of the dangers associated with benzodiazepines and opioids, and didn’t want to be a statistic. OxyContin became less effective and I didn’t want to up my dosage,” recounts Ameling. “By using cannabis as an adjunct to my therapy, I was able to cut back on all my medications. Most impressively, while reducing my OxyContin intake, it didn’t become less effective, and in fact, I believe cannabis allows OxyContin to be maintain efficacy far longer than typical.  

Ameling noted everyone responds differently, but for him, “low dose edibles work much better than smoking. In fact, smoking seems to worsen my symptoms, while edibles clearly improve them.”

Final Considerations & Tips

Chronic pain sufferers have turned to cannabis for years, long before more than half of the U.S. legalized medical marijuana. Encouragingly, over recent years, research is starting to catch up — although far more is needed — and, an ever-increasing body of evidence validates what medical marijuana chronic pain patients have known for years.

While the evidence is compelling — particularly for the treatment of neuropathic pain — it’s important for patients to recognize that strains can vary considerably in chemical composition. Moreover, choice of delivery device influences outcomes. It may take a little trial and error before you find the most effective strain and preferred form of administration. Most importantly, if you are currently using opioids, it would be unwise to radically change your treatment protocol without professional medical supervision.

Key Tips:

  • Administration Method Matters: Keep in mind that method of administration is important. An edible will have a different effect than vaporizing. Vaporizing will elicit different effects from a tincture. And, of course, prescription formulation. While anecdotally, many patients report a preference for edibles, everyone is different, so you may want to experiment with different methods until you find what works best.
  • It May Take Some Trial & Error: Different strains will elicit different effects that are THC and CBD dose-dependent Further, differing ratios of THC will impact the effect. Similar to how people respond differently to the same drug, people will have different experiences that may be affected by the diverse composition among strains.
  • Most (But, Not All) Patients Prefer Indica: A 2016 study published in the Journal of Studies in Drugs and Alcohol found that pain patients preferred indica strains over sativa.
  • Exercise Caution If Currently Using Opioids: If you’re currently taking prescription opioids, exercise caution as withdrawal from opioids can be severe. Protocol changes should be monitored by a physician. Withdrawal from opioids can be severe!

Dr. Michael Hart, head physician at Marijuana for Trauma in Canada, advises: “When considering cannabis to treat chronic pain, the adage — less is more — rings true. Patients seem to find more relief in Indica strains which are higher in THC than most Sativa or Hybrid strains. But, what we’ve found is that these strains can be highly effective in low to moderate doses, but could actually make pain worse in higher doses. So it’s important to start low, and titrate up as appropriate.”
 

References

Cannabis & Pain Management

Donald I. Abrams, MD.  

Department Anesthesia, Psychiatry, Dalhousie University, Halifax, Canada. Mary Lynch, MD; et, al.

Harvard Medical School. Kevin Hill, MD.

Ethan Russo, MD.

Department of Pain Pharmacology, Polish Academy of Sciences. Barbara Przewlocka, Katarzyna Starowicz, Ph.D.

J Manzanares, MD; et, al.

Division of Hematology, Oncology and Transplantation and the Vascular Biology Center, University of Minnesota. Pankaj Gupta, MD; et, al.

Department of Psychological Brain Sciences, Indiana University. Andrea Hohmann, Ph.D., Ethan Russo, MD.  

 

Cannabis & Opioids

Centers for Disease Control.

Division of Hematology-Oncology, San Francisco General Hospital, University of California, San Francisco. Donald Abrams, MD; et, al.

National Center for PTSD, Veterans Affairs Palo Alto Health Care System. Marcel Bonn-Miller; et, al.

University of Michigan, Medical School. Kevin F. Boehnke, MD; et, al.

Department of Psychology, Ariel University, Ariel, Israel. D. Feingold, MD; et, al.

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Super Silver Haze
(4)
Sativa - THC 23%
Titanium
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Hybrid - THC 22%
Top 44
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Indica - THC 20%
X-Kush #1
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Indica - THC 21%
Albert Walker
Leave a review
Indica - THC 15%
Anunnaki
Leave a review
Sativa - THC 19%
Chernobyl
(7)
Sativa - THC 30%
Chocolate Haze
(1)
Sativa - THC 17%
Chocolate Thai
(2)
Sativa - THC 10%
Cole Train
Leave a review
Indica - THC 19%
Destroyer
Leave a review
Sativa - THC 23%
F.O.G.
(1)
Sativa - THC 21%
Flying Dragon
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Hybrid - THC 18%
Golden Tiger
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Sativa - THC 24%
Jack's Cleaner
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Sativa - THC 17%
La Blanca
(1)
Indica - THC 15%
Lowryder
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Sativa - THC 14%
Obsession
(1)
Indica - THC 19%
Rug Burn OG
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Indica - THC 26%
Sonoma Coma
(2)
Sativa - THC 25%
Super Lemon Haze
(4)
Sativa - THC 25%
The Black
(1)
Indica - THC 18%
Arjan's Haze
Leave a review
Sativa - THC 22%
Cannatonic
(3)
Hybrid - THC 6%
Crimea Blue
(1)
Indica - THC 18%
Flowerbomb Kush
Leave a review
Sativa - THC 19%
Holy Grail Kush
(4)
Indica - THC 24%
M-39
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Hybrid - THC 14%
Madness
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Hybrid - THC 18%
Mazar
(1)
Indica - THC 20%
Motavation
Leave a review
Indica - THC 18%
Pineapple Punch
Leave a review
Sativa - THC 15%
Purple Haze
(5)
Sativa - THC 20%
Durban Poison
(16)
Sativa - THC 26%
Deadhead OG
(1)
Sativa - THC 25%
Tangerine Dream
(2)
Sativa - THC 25%
Sweet Tooth
(1)
Indica - THC 19%
Bruce Banner
(5)
Sativa - THC 30%
Death Star
(5)
Indica - THC 26%
Flo
(2)
Sativa - THC 14%
Jean Guy
(1)
Sativa - THC 25%
Mars OG
(1)
Indica - THC 20%
Obama Kush
(3)
Indica - THC 21%
Trinity
(5)
Sativa - THC 20%
Ghost Train Haze
(3)
Sativa - THC 25%
Cannalope Kush
(1)
Sativa - THC 22%
Gigabud
(1)
Indica - THC 19%
$100 OG Kush
(1)
Hybrid - THC 25%
Super Sour Diesel
(1)
Sativa - THC 26%
Hash Plant
(2)
Indica - THC 13%
Cinex
(1)
Sativa - THC 26%
Sour Kush
Leave a review
Indica - THC 26%
Blue Diesel
(2)
Indica - THC 23%
A-10
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Indica - THC 24%
Afwreck
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Sativa - THC 26%
Blue Dragon
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Indica - THC 24%
Chemdawg 4
(1)
Indica - THC 28%
Great White Shark
(1)
Indica - THC 24%
J1
Leave a review
Sativa - THC 23%
King Louis XIII
(2)
Indica - THC 28%
Strawberry Diesel
(2)
Hybrid - THC 27%
Yoda OG
(3)
Indica - THC 22%
Golden Goat
(4)
Sativa - THC 23%
God Bud
(3)
Indica - THC 27%
Candyland
(4)
Sativa - THC 19%
Grand Daddy Purple
(11)
Indica - THC 23%
Purple Urkle
(3)
Indica - THC 26%
Tangerine Man
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Sativa - THC 18%
Raspberry Cookies
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Indica - THC 26%
Raspberry Kush
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Indica - THC 17%
Thin Mint Cookies
(4)
Hybrid - THC 24%
Hurricane
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Sativa - THC 18%
Snow Ryder
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Indica - THC 23%
Purple Trainwreck
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Hybrid - THC 26%
Super Skunk
(1)
Indica - THC 28%
Purple Headband
Leave a review
Indica - THC 28%
Sour OG
(4)
Hybrid - THC 27%
Animal Cookies
(3)
Indica - THC 27%
Candy Jack
(1)
Sativa - THC 27%
Stardawg
(10)
Sativa - THC 22%
Grape Stomper
(2)
Sativa - THC 22%
Critical Jack
(2)
Sativa - THC 20%
Pineapple Chunk
(2)
Indica - THC 26%
Khalifa Kush
(5)
Indica - THC 29%
White Fire OG
(3)
Indica - THC 25%
Bubba's Gift
Leave a review
Indica - THC 20%
Green Goblin
(1)
Sativa - THC 24%
Purple Arrow
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Indica - THC 24%
Zombie OG
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Indica - THC 21%
Golden Pineapple
Leave a review
Hybrid - THC 29%
ACDC
(7)
Hybrid - THC 6%
Tres Dawg
(1)
Hybrid - THC 25%
Sour Jack
(2)
Hybrid - THC 22%
Rainbow Kush
Leave a review
Indica - THC 17%
Sour Tsunami
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Sativa - THC 10%
Goji OG
(1)
Hybrid - THC 22%
Plushberry
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Hybrid - THC 20%
Cherry AK-47
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Sativa - THC 21%
Blue Champagne
Leave a review
Sativa - THC 25%
Gorilla Glue #4
(22)
Sativa - THC 32%
Blue Widow
(2)
Indica - THC 17%
Chemdawg Sour Diesel
Leave a review
Sativa - THC 26%
Tangie
(3)
Sativa - THC 22%
Blueberry
(7)
Indica - THC 24%
Afghani
(1)
Indica - THC 21%
Triangle Kush
(2)
Indica - THC 26%
Alien Kush
Leave a review
Indica - THC 19%
Purple Jems
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Hybrid - THC 19%
Alien Technology
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Indica - THC 19%
White Nightmare
(2)
Sativa - THC 22%
White Moonshine
Leave a review
Indica - THC 19%
Larry OG
(3)
Indica - THC 24%
Hawaiian Haze
(1)
Sativa - THC 26%
Hawaiian
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Sativa - THC 25%
West Coast Diesel
(1)
Sativa - THC 26%
Twilight
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Indica - THC 21%
Khufu
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Indica - THC 27%
Happy Kush
Leave a review
Indica - THC 19%
Blue Moonshine
Leave a review
Indica - THC 16%
Black Cherry Soda
(1)
Hybrid - THC 30%
Purple Power
(1)
Sativa - THC 20%
Jamaican
(2)
Sativa - THC 21%
Ice Queen
Leave a review
Sativa - THC 23%
Oriental Express
Leave a review
Sativa - THC 16%
SAGE
(2)
Sativa - THC 25%
Chemdawg 91
(1)
Hybrid - THC 24%
Critical Plus
Leave a review
Hybrid - THC 20%
The White
(4)
Sativa - THC 30%
Nepali OG
(1)
Indica - THC 21%
Snow Lotus
Leave a review
Indica - THC 25%
Chem's Sister
Leave a review
Sativa - THC 28%
California Orange
Leave a review
Hybrid - THC 15%
Arcata Trainwreck
(1)
Sativa - THC 26%
Lost Coast OG
Leave a review
Indica - THC 15%
MK Ultra
(1)
Indica - THC 22%
Blue God
(1)
Indica - THC 20%
Blue Cookies
(1)
Indica - THC 25%
Blackwater
Leave a review
Indica - THC 20%
Bay Dream
Leave a review
Sativa - THC 26%
Alien OG
(4)
Sativa - THC 28%
Cookies and Cream
(2)
Hybrid - THC 25%
Double Dream
(1)
Sativa - THC 26%
Dr. Who
(1)
Hybrid - THC 30%
Gelato
(9)
Hybrid - THC 25%
Key Lime Pie
(2)
Hybrid - THC 25%
Monster Cookies
(2)
Indica - THC 16%
Mad Scientist
Leave a review
Indica - THC 24%
Bubblicious
Leave a review
Indica - THC 25%
Cali Kush
(1)
Indica - THC 15%
C4
Leave a review
Indica - THC 22%
Bordello
Leave a review
Indica - THC 20%
Blueberry Pie
(1)
Hybrid - THC 20%
Apple Kush
Leave a review
Indica - THC 20%
Jesus OG
(1)
Hybrid - THC 28%
Cornbread
(1)
Indica - THC 20%
Moonwalker Kush
Leave a review
Hybrid - THC 28%
Charlotte's Web
(1)
Hybrid - THC 1%
Conspiracy Kush
(1)
Indica - THC 25%
Royal Kush
(1)
Indica - THC 25%
Grape Royale
Leave a review
Indica - THC 28%
Dirty Girl
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Sativa - THC 28%
Wedding Cake
(7)
Indica - THC 25%
UW
Leave a review
Indica - THC 20%
Emerald Jack
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Sativa - THC 20%
Cotton Candy Kush
Leave a review
Indica - THC 20%
Blueberry Cheesecake
Leave a review
Sativa - THC 20%
Blue Kush
Leave a review
Hybrid - THC 18%
Blue Ivy
(1)
Indica - THC 20%
Blue Haze
(1)
Indica - THC 26%
Isla OG
Leave a review
Hybrid - THC 27%
Boss Hogg
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Indica - THC 20%
Oracle
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Hybrid - THC 14%
Strawberry Banana
(2)
Indica - THC 33%
Purple Dragon
Leave a review
Sativa - THC 20%
Snoop's Dream
(2)
Hybrid - THC 25%
Presidential OG
(1)
Indica - THC 26%
Blue Mango
Leave a review
Indica - THC 18%
Cherries Jubilee
Leave a review
Indica - THC 22%
Dutch Hawaiian
Leave a review
Sativa - THC 28%
Lodi Dodi
(3)
Sativa - THC 28%
Head Cheese
(1)
Hybrid - THC 30%
Tiger's Milk
Leave a review
Hybrid - THC 17%
Malawi
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Sativa - THC 24%
Laughing Buddha
(2)
Sativa - THC 20%
Frank's Gift
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Sativa - THC 9%
Dream Star
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Indica - THC 25%
Cit·Rix
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Sativa - THC 23%
Crown Royale
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Indica - THC 22%
Fruit Loops
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Indica - THC 19%
Deep Purple
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Indica - THC 19%
Cherry Cookies
Leave a review
Hybrid - THC 26%
Banana OG
(1)
Indica - THC 25%
Hell's Angel OG
(1)
Indica - THC 20%
XXX OG
(2)
Indica - THC 21%
Cherry Pie
(6)
Indica - THC 26%
Rare Darkness
(1)
Indica - THC 26%
Starfighter
Leave a review
Indica - THC 26%
Blue Magoo
(1)
Indica - THC 21%
Liberty Haze
(2)
Hybrid - THC 29%
Sour Cream
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Sativa - THC 17%
Cheesequake
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Indica - THC 22%
Blue Boy
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Sativa - THC 27%
Blue Diamond
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Indica - THC 24%
Blue Dot
(1)
Sativa - THC 20%
Blue Frost
Leave a review
Indica - THC 22%
Blue Goo
(1)
Hybrid - THC 22%
Cannasutra
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Indica - THC 23%
Gucci OG
(1)
Hybrid - THC 30%
Presidential Kush
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Indica - THC 30%
Alien Rift
(1)
Indica - THC 24%
Boy Scout Cookies
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Hybrid - THC 24%
Paris OG
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Indica - THC 28%
Blowfish
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Indica - THC 26%
Black Russian
Leave a review
Indica - THC 26%
Black Mamba
(1)
Indica - THC 25%
Black Ice
(1)
Indica - THC 24%
Black Haze
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Sativa - THC 22%
Black Diamond
(3)
Indica - THC 24%
Alien Rock Candy
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Indica - THC 18%
Pink Champagne
Leave a review
Indica - THC 23%
Pink Panties
(1)
Indica - THC 24%
Emerald OG
(1)
Indica - THC 22%
Pink Death Star
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Indica - THC 23%
Sour Patch Kiss
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Sativa - THC 31%
Blue Venom
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Indica - THC 23%
Blue Thai
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Hybrid - THC 21%
Blue OG
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Indica - THC 19%
Blue Nightmare
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Hybrid - THC 19%
Blue Knight
(1)
Hybrid - THC 27%
Blue Power
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Indica - THC 27%
Blue Sky
Leave a review
Indica - THC 19%
9 Pound Hammer
(6)
Indica - THC 23%
Huckleberry
(1)
Hybrid - THC 26%
Cookie Monster
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Indica - THC 23%
Bubba OG
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Indica - THC 27%
Berry Bomb
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Indica - THC 23%
Afgoo
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Indica - THC 30%
Blurple
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Hybrid - THC 19%
Dr. Feelgood
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Hybrid - THC 20%
Abusive OG
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Indica - THC 32%
Cherry Skunk
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Indica - THC 22%
Cherry OG
(1)
Hybrid - THC 23%
Charlie Sheen
(1)
Sativa - THC 24%
Tutti Frutti
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Hybrid - THC 23%
24K Gold
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Indica - THC 24%
3x Crazy
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Hybrid - THC 23%
Bubbleberry
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Sativa - THC 21%
Syrup OG
(1)
Indica - THC 30%
Harambe's Ghost
Leave a review
Hybrid - THC 30%
Cheese Candy
(1)
Sativa - THC 20%
Chocolate Kush
(1)
Indica - THC 28%
Cookie Dough
(1)
Hybrid - THC 25%
Diamond OG
(1)
Indica - THC 22%
Frankenstein
(1)
Indica - THC 29%
Euphoria
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Indica - THC 6%
Euforia
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Sativa - THC 23%
Gobbstopper
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Hybrid - THC 21%
Fruit Punch
(1)
Sativa - THC 25%
Herojuana
(1)
Indica - THC 29%
King Kong
(1)
Indica - THC 21%
Orange Creamsicle
(2)
Sativa - THC 18%
Critical Kush
(1)
Indica - THC 29%
Crown OG
Leave a review
Indica - THC 28%
Dairy Queen
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Hybrid - THC 28%
Deep Sleep
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Indica - THC 20%
Dizzy OG
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Hybrid - THC 22%
K2
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Indica - THC 29%
Lucky Charms
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Hybrid - THC 22%
Pez
Leave a review
Indica - THC 27%
THC Bomb
(2)
Hybrid - THC 26%
Jager
(4)
Indica - THC 23%
Lucid Dream
Leave a review
Sativa - THC 28%
Memory Loss
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Sativa - THC 28%
Pitbull
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Indica - THC 21%
CBD Kush
Leave a review
Indica - THC 8%
Somango
(2)
Indica - THC 23%
Sexxpot
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Indica - THC 15%
LA Woman
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Hybrid - THC 28%
Mountain Girl
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Hybrid - THC 20%
Transformer
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Hybrid - THC 22%
Lemon Cake
(2)
Sativa - THC 25%
Irish Cream
(1)
Indica - THC 20%
Blueberry Diesel
Leave a review
Indica - THC 23%
Blueberry Haze
Leave a review
Sativa - THC 23%
Green Goddess
Leave a review
Indica - THC 20%
Hippie Crippler
(1)
Hybrid - THC 27%
Jedi Kush
Leave a review
Indica - THC 30%
Lemon Haze
(3)
Sativa - THC 25%
Citrus Sap
(1)
Sativa - THC 24%
Colombian Gold
(2)
Sativa - THC 20%
Deep Chunk
Leave a review
Indica - THC 20%
Dog Shit
Leave a review
Sativa - THC 26%
Early Girl
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Indica - THC 20%
Game Changer
(1)
Indica - THC 29%
Hong Kong
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Hybrid - THC 25%
Cabbage Patch
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Hybrid - THC 27%
Earth OG
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Indica - THC 22%
Exodus Cheese
(1)
Hybrid - THC 18%
Goo
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Indica - THC 24%
Locomotion
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Indica - THC 23%
Milky Way
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Sativa - THC 22%
Blueberry Yum Yum
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Sativa - THC 25%
Haole
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Indica - THC 17%
Hog
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Indica - THC 23%
Ingrid
(1)
Indica - THC 25%
Killer Queen
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Hybrid - THC 21%
Kong
(1)
Hybrid - THC 20%
Lifesaver
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Hybrid - THC 21%
Atomic Northern Lights
Leave a review
Indica - THC 24%
Pie Face
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Indica - THC 19%
Royal Dutch
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Hybrid - THC 21%
Recon
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Indica - THC 23%
Remedy
(1)
Indica - THC 1%
Shark's Breath
Leave a review
Indica - THC 26%
Sunshine
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Sativa - THC 27%
Sweet Dream
Leave a review
Sativa - THC 23%
Do Si Do
(3)
Hybrid - THC 30%
True OG
(1)
Hybrid - THC 24%
Venom OG
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Hybrid - THC 27%
Acid
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Indica - THC 23%
Afghan Cow
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Sativa - THC 22%
Alaska
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Sativa - THC 31%
Aloha
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Sativa - THC 24%
Armageddon
(1)
Sativa - THC 20%
Butter OG
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Indica - THC 24%
Cali Gold
Leave a review
Indica - THC 21%
U.K. Cheese
(1)
Hybrid - THC 18%
Gooberry
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Hybrid - THC 20%
Green Monster
Leave a review
Hybrid - THC 27%
ICED Grapefruit
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Sativa - THC 24%
Julius Caesar
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Hybrid - THC 20%
Lemon Jack
(1)
Sativa - THC 18%
Lemon Pie
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Sativa - THC 22%
Mother’s Milk
Leave a review
Sativa - THC 16%
Night Nurse
(2)
Indica - THC 21%
OG Cheese
(1)
Indica - THC 18%
Medicine Woman
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Sativa - THC 24%
Money Maker
(2)
Indica - THC 23%
Moonshine Haze
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Sativa - THC 25%
OG 18
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Indica - THC 20%
Omega
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Hybrid - THC 26%
Orange Kush
(2)
Hybrid - THC 24%
Orange Velvet
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Hybrid - THC 22%
Oregon Diesel
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Indica - THC 22%
Pineapple Jack
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Hybrid - THC 20%
Red Diesel
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Hybrid - THC 22%
Shishkaberry
(3)
Indica - THC 26%
Silver Pearl
Leave a review
Sativa - THC 21%
Skunkberry
(1)
Hybrid - THC 40%
Skywalker OG
(12)
Indica - THC 26%
Sour Apple
Leave a review
Indica - THC 27%
Sour Bubble
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Indica - THC 28%
Sour Candy
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Sativa - THC 16%
Sour Cookies
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Sativa - THC 28%
Bubblegum Kush
(2)
Indica - THC 23%
Grape Cookies
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Indica - THC 24%
Grape Crush
Leave a review
Indica - THC 19%
Green Dragon
(1)
Indica - THC 16%
Green Dream
(1)
Hybrid - THC 24%
Green Love Potion
Leave a review
Indica - THC 24%
Incredible Bulk
(1)
Indica - THC 24%
LA Chocolat
Leave a review
Indica - THC 29%
Pineapple Thai
Leave a review
Sativa - THC 24%
Pink Lemonade
(1)
Indica - THC 22%
Platinum Kush
(2)
Indica - THC 17%
Power Kush
Leave a review
Hybrid - THC 19%
Pure Kush
Leave a review
Indica - THC 24%
Purple Berry
Leave a review
Indica - THC 22%
Purple Bud
(1)
Indica - THC 20%
Purple Candy
(1)
Hybrid - THC 19%
Purple Champagne
Leave a review
Sativa - THC 29%
Purple Cheese
Leave a review
Hybrid - THC 22%
Sour Dream
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Sativa - THC 21%
Sour Power
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Sativa - THC 29%
Space Cream
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Indica - THC 24%
Strawberry Blue
Leave a review
Sativa - THC 20%
Strawberry Cheesecake
Leave a review
Indica - THC 22%
Strawberry Dream
Leave a review
Hybrid - THC 21%
Strawberry Ice
(1)
Sativa - THC 21%
Strawberry Kush
(1)
Sativa - THC 23%
Strawberry
Leave a review
Hybrid - THC 18%
Sugar Mama
Leave a review
Hybrid - THC 19%
White Berry
(1)
Indica - THC 22%
White Cheese
Leave a review
Hybrid - THC 16%
White Cookies
(1)
Indica - THC 20%
White Dream
Leave a review
Hybrid - THC 24%
White Elephant
Leave a review
Hybrid - THC 23%
White Gold
Leave a review
Indica - THC 25%
White Lavender
Leave a review
Hybrid - THC 19%
Agent Tangie
(1)
Sativa - THC 18%
Super Blue Dream
(1)
Hybrid - THC 21%
Super Cheese
Leave a review
Indica - THC 25%
Super Jack
(1)
Sativa - THC 24%
Suzy Q
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Hybrid - THC 1%
Sweet Black Angel
Leave a review
Indica - THC 18%
Tangerine Kush
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Indica - THC 20%
Walter White
Leave a review
Sativa - THC 21%
The Sauce
Leave a review
Sativa - THC 28%
Tangerine Power
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Sativa - THC 25%
Arabian Gold
Leave a review
Hybrid - THC 22%
Godfather OG
(1)
Indica - THC 28%
Lemon G
(2)
Sativa - THC 23%
Lemon Thai
(2)
Hybrid - THC 22%
Mango
(1)
Hybrid - THC 24%
Locktite
Leave a review
Indica - THC 23%
Mango Tango
(1)
Indica - THC 26%
Pink Kush
(5)
Indica - THC 22%
Alien Bubba
Leave a review
Indica - THC 21%
Aurora Indica
Leave a review
Indica - THC 20%
Azure Haze
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Indica - THC 20%
Banana Candy
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Indica - THC 24%
Barbara Bud
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Indica - THC 19%
BC Big Bud
(1)
Sativa - THC 21%
BC Roadkill
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Indica - THC 25%
Belladonna
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Sativa - THC 26%
Birds Eye
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Hybrid - THC 25%
Black Bubba
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Indica - THC 24%
Mega Jackpot
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Sativa - THC 25%
Maui
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Sativa - THC 26%
Purple Cream
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Hybrid - THC 24%
Purple Dream
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Hybrid - THC 15%
test strain 1
Leave a review
Indica - 0%
Tangerine
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Hybrid - THC 18%
The Flav
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Indica - THC 24%
Tora Bora
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Indica - THC 22%
Black Velvet
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Hybrid - THC 20%
Blackberry Cream
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Indica - THC 25%
Blackberry Haze
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Sativa - THC 24%
Blackberry Trainwreck
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Hybrid - THC 20%
Oaxacan Highland
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Sativa - THC 23%
Puna Budder
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Hybrid - THC 22%
Martian Candy
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Indica - THC 21%
Medusa
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Hybrid - THC 20%
Monkey Paw
(1)
Indica - THC 23%
Wappa
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Indica - THC 22%
Purple Goo
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Hybrid - THC 21%
Purple Gorilla
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Indica - THC 21%
Purple Nepal
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Indica - THC 25%
Night Train
(1)
Hybrid - THC 23%
Purple Skunk
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Sativa - THC 20%
Purple Star
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Indica - THC 13%
Purple Thai
(1)
Sativa - THC 24%
Purple Voodoo
(2)
Hybrid - THC 16%
White Lotus
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Hybrid - THC 22%
White Siberian
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Indica - THC 15%
White Slipper
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Sativa - 70%
Blue Lights
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Indica - THC 16%
Jack's Girl
(2)
Hybrid - THC 54%
Purple Wreck
(1)
Indica - THC 31%
Blue Monster
(1)
Indica - THC 23%
Blue Satellite
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Hybrid - THC 22%
Blue Train
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Hybrid - THC 20%
Buddha Haze
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Sativa - THC 26%
Cambodian
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Sativa - THC 26%
Catfish
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Sativa - THC 20%
Chiquita Banana
(2)
Hybrid - THC 34%
Chocolate Fondue
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Sativa - THC 17%
Citrus Kush
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Indica - THC 18%
Colorado Chem
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Hybrid - THC 22%
Cookie Jar
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Indica - THC 24%
Crosswalker
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Indica - THC 22%
Death Bubba
(2)
Indica - THC 27%
Double Diesel
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Sativa - THC 22%
Double OG
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Indica - THC 26%
Dreamer's Glass
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Sativa - THC 22%
Early Pearl
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Sativa - THC 24%
Earthquake
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Hybrid - THC 23%
Red Poison
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Hybrid - THC 21%
Easy Bud
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Sativa - THC 17%
Enigma
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Sativa - THC 24%
Red Cherry Berry
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Hybrid - THC 22%
Ether
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Indica - THC 21%
Ray Charles
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Indica - THC 21%
G.O.A.T.
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Sativa - THC 19%
Raw Diesel
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Hybrid - THC 19%
Rafael
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Sativa - THC 2%
Grape Skunk
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Indica - THC 24%
Grapefruit Haze
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Hybrid - THC 25%
Green Hornet
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Hybrid - THC 20%
Green Kush
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Hybrid - THC 24%
Green Poison
(1)
Indica - THC 20%
Harry Potter
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Hybrid - THC 17%
Hawaiian Delight
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Hybrid - THC 20%
Quebec Gold
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Hybrid - THC 26%
Himalayan Gold
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Indica - THC 25%
Pure Power
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Sativa - THC 26%
Hindu Skunk
(1)
Indica - THC 23%
Hollywood OG
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Hybrid - THC 20%
Silver Kush
(1)
Sativa - THC 24%
Holy Ghost
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Hybrid - THC 28%
Honey Boo Boo
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Indica - THC 21%
Humboldt
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Hybrid - THC 25%
Jack Diesel
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Sativa - THC 23%
Jacky White
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Sativa - THC 18%
Jamaican Lion
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Hybrid - THC 18%
Jenni
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Sativa - THC 11%
Shaman
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Sativa - THC 18%
Juicy Jack
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Hybrid - THC 25%
Juliet
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Sativa - THC 20%
Seattle Blue
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Hybrid - THC 20%
Sapphire Star
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Hybrid - THC 24%
Santa Maria
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Sativa - THC 14%
Rubicon
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Hybrid - THC 9%
K-Train
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Hybrid - THC 22%
K1
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Sativa - THC 16%
Kali Dog
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Sativa - THC 26%
King's Bread
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Sativa - THC 21%
LA Kush
(1)
Indica - THC 21%
Royal Highness
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Sativa - THC 15%
Rene
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Sativa - THC 18%
Lemon Marmalade
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Hybrid - THC 27%
Lime Green Skunk
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Hybrid - THC 17%
Liquid Butter
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Indica - THC 20%
Loud Scout
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Indica - THC 23%
Project Blue Book
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Hybrid - THC 22%
Magnum
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Hybrid - THC 15%
Mango Dream
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Hybrid - THC 23%
Master Bubba
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Hybrid - THC 8%
Pink Pez
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Hybrid - THC 23%
Pineapple Skunk
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Indica - THC 27%
Master Skunk
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Hybrid - THC 19%
Melon Gum
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Indica - THC 23%
Molokai Frost
(1)
Sativa - THC 70%
Monster OG
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Indica - THC 26%
Morning Star
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Sativa - THC 24%
Mother of Berries
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Indica - THC 24%
Ms Universe
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Hybrid - THC 24%
Mt Cook
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Indica - THC 23%
Mt Rainier
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Hybrid - THC 23%
Neptune OG
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Hybrid - THC 23%
Nova
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Indica - THC 23%
NYPD
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Sativa - THC 24%
Odyssey
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Hybrid - THC 22%
OG Skunk
(1)
Sativa - THC 26%
Old Toby
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Indica - THC 18%
Orange Haze
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Sativa - THC 20%
Orange Skunk
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Sativa - THC 16%
Orange Turbo
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Sativa - THC 15%
Ortega
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Indica - THC 17%
Pineapple Diesel
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Hybrid - THC 18%
Purple Sour Diesel
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Sativa - THC 21%
Skunk 47
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Indica - THC 27%
Sour Bubba
(1)
Sativa - THC 31%
Star Berry
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Indica - THC 20%
Stevie Wonder
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Sativa - THC 24%
Strawberry Lemonade
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Hybrid - THC 28%
Sweet Deep Grapefruit
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Indica - THC 19%
Sweet Pebbles
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Hybrid - THC 20%
Swiss Gold
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Indica - THC 7%
Thai Haze
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Hybrid - THC 21%
The Doctor
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Indica - THC 23%
The Ox
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Indica - THC 20%
Tree of Life
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Sativa - THC 22%
Triple Diesel
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Hybrid - THC 22%
Verde Electric
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Hybrid - THC 24%
King Kush
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Indica - THC 20%
White Skunk
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Indica - THC 22%
8 Ball Kush
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Indica - THC 18%
Cadillac Purple
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Hybrid - THC 27%
Early Skunk
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Indica - THC 22%
Frostbite
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Sativa - THC 21%
Fruity Chronic Juice
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Indica - THC 20%
G13 Haze
(1)
Indica - THC 24%
Gorilla Glue #5
(2)
Indica - THC 28%
Whitaker Blues
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Indica - THC 28%
White Haze
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Sativa - THC 19%
White Kush
(1)
Indica - THC 29%
White Smurf
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Hybrid - THC 22%
White Strawberry
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Hybrid - THC 18%
Wonder Haze
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Sativa - THC 22%
Woody Kush
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Indica - THC 23%
Willie Cheesie
(2)
Hybrid - THC 20%
Special K
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Hybrid - THC 24%
Spirit of 76
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Hybrid - THC 12%
Sugar Black Rose
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Indica - THC 18%
Super Bud
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Indica - THC 19%
Super Kush
(1)
Hybrid - THC 22%
Supernatural
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Sativa - THC 22%
Supernova
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Indica - THC 25%
Sweet Berry
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Hybrid - THC 21%
Wreckage
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Hybrid - THC 21%
Fifth Element
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Indica - THC 22%
A-Dub
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Hybrid - THC 30%
Aberdeen
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Sativa - THC 15%
Ace Killer OG
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Indica - THC 27%
Afghan Diesel
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Hybrid - THC 23%
African
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Sativa - THC 10%
Afternoon Delight
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Sativa - THC 18%
Alchemy
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Hybrid - THC 22%
Alf
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Indica - THC 15%
Alice In Wonderland
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Sativa - THC 23%
Alien Inferno
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Indica - THC 20%
Alien Reunion
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Hybrid - THC 28%
Alpha Cow
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Sativa - THC 22%
American Kush
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Indica - THC 27%
Amethyst
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Indica - THC 20%
Ancient OG
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Indica - THC 21%
Anesthesia
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Indica - THC 19%
Apple Jack
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Hybrid - THC 20%
ArcticBlue
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Indica - THC 21%
Area 51
(1)
Hybrid - THC 23%
Secret Recipe
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Sativa - THC 25%
Reggie
(1)
Sativa - THC 20%
Argyle
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Indica - THC 13%
Ash
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