In February 2019, the British Journal of Anaesthesia published a scientific paper reporting one of the most curious cannabinoid-related studies known to the scientific world. This case reached the media almost instantly, and has been widely discussed due to its important significance for the already fast-growing medical cannabinoid market.
At 66-years old, Jo Cameron entered the Raigmore Hospital in Inverness, Scotland, to undergo a specific type of orthopaedic surgery known as trapeziectomy, due to severe osteoarthritis in the hands. Although her fingers were severely deformed and she could barely use her right thumb, she felt no pain whatsoever. The doctors may have found this a bit weird, as these types of lesions are usually painful, but they proceeded with the operation as usual. After the trapeziectomy, shockingly, her pain intensity score was 0/10. She was discharged and sent home the next day, having required no postoperative analgesics other than one gram of paracetamol.
Surprisingly, this wasn’t the first time something like this had happened. One year before, Jo had been submitted to a hip replacement surgery, showing similar behaviour. According to the scientists, “[she] was administered only paracetamol 2 g orally on Postoperative days 1 and 2, reporting that she was encouraged to take the paracetamol, but that she did not ask for any analgesics (…). After the operation, her pain intensity scores were 0/10 throughout except for one score of 1/10 on the first postoperative evening”. Similarly, in the past, she had also undergone multiple dental surgery and varicose vein procedures, not requiring any type of analgesics.
According to the study, “she also reported a long history of painless injuries (e.g. suturing of a laceration and left wrist fracture) for which she did not use analgesics. She reported numerous burns and cuts without pain, often smelling her burning flesh before noticing any injury, and that these wounds healed quickly with little or no residual scar. She reported eating Scotch bonnet chilli peppers without any discomfort, but a short-lasting ‘pleasant glow’ in her mouth. She described sweating normally in warm conditions.”
At age 67, when the doctors started to notice her incredible history, pain genetics teams from the Universities College London and Oxford started to further investigate her condition.
Jo is described by the scientists as “talkative and happy with an optimistic outlook”. She took anxiety and depression tests, scoring 0/21 and 0/29, respectively, which are the lowest categories on both scales. Other than this very optimistic way of being, she reported having very high tolerance to heat, some memory lapses (like forgetting words mid-sentence, or where she put her keys), and not feeling fear or panic, not even in dangerous situations like a recent road traffic accident.
Turns out, Jo has a combination of two DNA mutations, which causes her fatty-acid amide hydrolase (FAAH) enzymes to malfunction. FAAHs breakdown endocannabinoids, such as anandamide (also known as AEA), which are essential components in the mechanisms of pain reception, fear-extinction memory, anxiety, and depression. Being unable to breakdown AEA and other compounds that act on the endocannabinoid system, both Jo’s blood and brain showed high levels of them, which therefore caused symptoms like lack of pain, fear, anxiety, or depression.
According to the scientists, this case opens up new possibilities regarding the study of the endocannabinoid system and its use in the treatment of conditions like chronic pain.
According to a 2016 study, AEA is thought to be directly linked to states of happiness and pleasure, and DNA mutations that incapacitate FAAH (such as the one seen in Jo) are associated with higher happiness indexes.
In fact, these endocannabinoids are much like our or own personal cannabis. They are an integral part of our endocannabinoid system, and our innate receptors that are meant for these endocannabinoids are the same that are used by external compounds, like the ones in cannabis (such as THC and CBD), to exert their effects on our bodies.
Particularly in the case of CBD, and although studies have shown it may not have that much affinity to our cannabinoid receptors, one study published in the prestigious scientific journal Nature reports that CBD can increase AEA levels in the blood (much like Jo’s mutations do). According to the scientists, this mechanism may contribute to the antipsychotic effects of CBD and be of use in developing new treatments for schizophrenia.
In sum, the human body comes with a natural way of producing and processing certain types of cannabinoids, which have very positive effects in our happiness, well-being, and sense of pleasure. These studies on the endocannabinoid system and cases like Jo’s may shed some light on how scientists can harvest this power to make use of the endocannabinoid system, cannabis, CBD, and other cannabinoids in a medical context, working to prevent and treat conditions like anxiety, depression, or chronic pain.