Healthcare is in the midst of a sea change, or, more accurately, several concurrent sea changes. Behind the very public debate over the federal government’s role in healthcare, one of these smaller shifts—yet one equally tectonic in its implications—is the role of clinical cannabis in treating chronic conditions such as pain.

Until relatively recently, chronic pain was seen as merely a symptom of other, more readily diagnosable conditions. But increasingly, chronic pain is considered to be a disease in its own right, with a long and sobering list of symptoms and repercussions such as depression, immobility, insomnia, malnutrition, anxiety, and worse.

This is welcome news for the roughly 100 million Americans who suffer from chronic pain—incurring a stunning $600 billion annually in medical treatments and lost productivity, according to a 2011 report—but in many regards, the medical establishment’s response has been woefully inadequate. While our understanding of chronic pain has evolved, the first-line treatment has mostly regressed to a Victorian-era response in the form of a massive and objectively harmful flood of opioids.

Derived from the same poppy precursor as heroin, opioids are powerful pain-killing medications that, broadly speaking, mimic our body’s’ endogenous neurotransmitters to block pain, slow breathing and produce a calming effect. In cases of acute trauma, they’re a time-honored and effective treatment for severe, short-term pain. But their effectiveness is undercut by their manifestly addictive qualities, sparked by the release of euphoria-producing dopamine they trigger. In short, using them to manage long-term pain introduces far more risks than rewards.

From multiple perspectives, reliance on opioids to treat chronic pain is unsustainable. By any objective measure, this country is caught in an epidemic of abuse, with widespread and rampant addiction, drug-related crime and suicides on the rise, particularly among veterans, who are prescribed these drugs in alarming numbers. Ironically, it’s cannabis—just now sloughing off its reputation as a street drug—that may show the greatest potential for treating and managing chronic pain.

Cannabis has many upsides: It’s demonstrably safer than opioids in terms of the risk of overdose, the potential for habit formation, and the general attritional effects of opioids’ sedative properties. As reported on, a Harvard-led review of 28 studies examining the pain-killing efficacy of exo-cannabinoids—either from cannabis plants or synthesized in the lab—found broad and substantiated evidence of their effectiveness.

What’s more, the effects of cannabis aren’t limited to only fighting pain; a 2016 study commissioned by the University of Michigan found that, in addition to reducing the use of opioids an average of 64%, using cannabis decreased side effects from other medications and broadly improved subjects’ quality of life.

Rigorous, authoritative studies have been difficult to conduct in this country due to federal drug statutes, but expect to see many others in the months and years to come. Obviously, we can’t predict their findings ahead of time, but a few trends are crystal-clear: Cannabis is going to find increasingly extensive use in a variety of clinical applications, and as its acceptance in the medical establishment grows. It’s going to replace opioids and other pharmaceuticals as first-line treatment for many common conditions, most notably the management of chronic pain.

In the years to come, look for increasingly granular research as we decode which strains, cannabinoids, and terpenes are most effective at achieving specific results. It’s an incredibly exciting time to be exploring this cutting-edge—yet incredibly ancient—medicine. And most importantly, it’s an endeavor that’s bringing real, sustainable relief to millions of Americans living with debilitating conditions like chronic pain.