Pain Matters Podcast Network · AAPM - American Academy of Pain Medicine

Navigating Cannabis in Pain Medicine [Part 2]

·35 min·2 clips

A 16-to-32 ng/ml THC range “seems to be” the sweet spot for pain relief.

Shravani continues the conversation with Dr. Mark Wallace from UCSD. The discussion stays focused on medicinal cannabis and keeps drawing a line between therapeutic use and recreational use. Wallace points to a study on car accidents to show why alcohol and THC together are a poor mix. He notes that alcohol alone slows reaction time, and that THC can make the picture worse. He then contrasts that with THC used on its own. Driving simulation studies come up as a controlled way to study impairment. The practical issue is not just how someone feels, but how police and traffic enforcement read impairment. Wallace says the field still has a long way to go on THC blood levels. Breathalyzers are getting better, but he does not treat them as ready for routine use by cops. His advice to patients is direct: he may consider a person safe to drive, but that does not mean they will not be stopped or prosecuted if they test positive for THC. That is why documentation matters so much. He compares the situation to opioids and the way clinicians document therapy, follow-up, and the absence of intoxication. He describes recording that patients are ambulatory unassisted and showing no signs of intoxication. The discussion then shifts to trial design. The research discussed here used inhalation, with a very controlled protocol meant to better manage blood levels for research purposes. Even in that setting, the blood levels were more variable than expected. Wallace suggests inhalation technique may explain some of that spread. The discussion also raises BMI and body habitus as possible factors, while leaving the question open. By the close, the tone stays careful and procedural, with a clear recognition that institutions and states shape practice. The result is a practical, technically literate conversation about a topic that is still widely misunderstood.

As heard by us

A grounded look at cannabis, impairment, and the limits of certainty.

Dr. Wallace keeps the focus on practical questions: how medicinal and recreational use differ, why alcohol and THC can be a rough mix, and what clinicians can actually write down when impairment is disputed.

Read the full review in PlayNext →

Why you'd press play

Need a provider-level way to talk about medical marijuana, driving, and THC testing?

Read the full recommendation in PlayNext →

Listen to the show on

Apple Podcasts Spotify

Play clips from this episode More from Pain Matters Podcast Network