[Closed] Dope as a pain killer.

Do you think using prescription medications, some addictive, with hundreds of side effects is fine, but using MJ isn't?

Because its not legal in the UK?

No - I think using cannabis in this situation is damaging. As I have repeatedly said it can have medical uses.

You really think cannabis has no side effects?

I didn't say marijuana had no side effects. It has far fewer, and less severe side effects than Amitriptyline for example, which is probably what she would get prescribed if she went to a GP.

If you knew anything about GP's, medicine, marijuana, or CFS, you wouldn't be so quick to rubbish my advice/experiences.

All this talk of cannabis is effecting your grammar and spelling, I prescribe shutting the **** up!
Zippykona probably thinks you two are right pair of ****ers, he'd be right.

This thread could do with a chill pill.

[b]Monday morning bong anyone ? [/b]

Certainly get work off to a good start whatever profession your in !

Pogo - Member

All this talk of cannabis is effecting your grammar and spelling,

Affecting. 🙂

My elderly step father who had suffered with sever back problems for twenty odd years after an accident at work, finally found great relief from smoking weed after being recommended by a friend.

but... now in my mid 40's I can look back at all the habitual weed smokers I've known over the years and can honestly say that not a single one of them is what you could call a fully functioning member of society. They seem to fall into two categories.. The pale paranoid/schizophrenic type with serious mental issues or the new age s****ing bafoon type who cant seem to hold down a regular job and suffer made up illnesses.

Hahahaha!

Modern medicine is completely ignoring one of the greatest resources our race has ever had, herbal remedies.

As long as it continues to do so it will continue to remain a farce that serves only as a means by which evil bastards make money.

I am not surprised that a great many individuals conform to the idea that it is some how effective and efficient, the reality however is that it treats and treats and treats and treats and treats and treats people, which of course generates money.

A far more effective way of promoting health and well being would be to educate people about healthy living and proper diet, however the people who control modern medicine would not make any money from that so it isn't very popular.

Now as I have said, talking shite about modern drugs and pain management isn't what this thread is about, it's about cannabis or similar substances being used as pain killers or to eleviate suffering, yes I know people who haven't used them for this reason are the best people to contribute to a thread about thier use 😯

Why not STFU and let the actual people who have used it for this reason contribute, the pharmaceutical companies have plenty of ways to sell and promoter thier filth, you can go back to being brain washed minions later on!

Well said Kaesae.

Wake and Bake! 8)

Wake and Bake!

😆

Take note of what they have to say at 6:35

There is a name for herbal remedies that work - medicine.

side effects of cannabis - delusions and paranoia.

TJ - in the nicest way possible, watch that video and STFU.

Of the 4 or so (not a massive amount I agree) stoners that regularly smoke more than once a day, who started at school, all of them are ****ed up. 2 have been sectioned, one is just a zombie drone, one is freaked out.

i'll bake the occassional cake, but I wouldn't want to have to 'rely' on dope for help.

I'm back...!

Modern medicine is completely ignoring one of the greatest resources our race has ever had, herbal remedies

What you really want to say is "modern medicine is completely ignoring [b]schedule 1 drugs[/b]" because they are illegal to prescribe (unless home office allowance) and do not have the evidence based backing.
("Tom down the pub" is not a reliable source of evidence base).

am not surprised that a great many individuals conform to the idea that it is some how effective and efficient, the reality however is that it treats and treats and treats and treats and treats and treats people, which of course generates money.

A far more effective way of promoting health and well being would be to educate people about healthy living and proper diet, however the people who control modern medicine would not make any money from that so it isn't very popular.

Finally - on the subject of CFS/ME/PVF/Fibromyalgia etc etc. Understandably anyone who suffers symptoms that cannot be fully explained, and hence ends up in one of these categories, will undoubatbly feel they have been 'failed' by the health service/GPs/hospitals. This may well be the case, I'm not sure (i think very few people are sure about these conditions TBH). That doesn't mean that help won't be offered. It might mean the 'help' you think you should be offered may not be.

DrP

Of the 4 or so (not a massive amount I agree) stoners that regularly smoke more than once a day, who started at school, all of them are **** up. 2 have been sectioned, one is just a zombie drone, one is freaked out.

Yet some of the most successful musicians, artists, etc in history smoked weed religiously. You have no way to know if your friends would have turned out that way whether they smoked weed or not.

The fact that people think its fine to take antidepressants everyday, yet find it wrong to use something that nature has provided for us just goes to show how brainwashed people are.

Flow you have no way of knowing whether cannabis helped or hindered them or had no eefect - perhaps they actually had talent?. Are you really claiming we could all be great musicians if we just consumed enough ?

Jesus wept I have smoked more than most humans alive and every day for over a decade [ not any more but I still do occassionally]
You are deluding yourself if you think it is a panacea for all ills or that it has made you see some sort of higher truth.
It does have an effect on you as well if you do it every day
Kaesae must at least believe me as i have done both so STFU apparently 😆

As long as it continues to do so it will continue to remain a farce that serves only as a means by which evil bastards make money.

I am not surprised that a great many individuals conform to the idea that it is some how effective and efficient,

Why not STFU and let the actual people who have used it for this reason contribute,

Kaeseae using your "logic" everything someone says to me about something they feel is "true" as they know better than anyone else

All the worlds religions become true [ even though they all say they are the only one,- STFU and practice this religion only then can you comment would be their counter] all treatments work if someone tells me it does.
It is not at all well thought out an approach to find truth
PLEASE READ PLACEBO

Thank god we actually employ science and reason to decide these things rather than stoners logic or Kaesaes ????- I done even know what to describe that as , even calling it thinking is flattering his posts- outpourings?

Nature provided us with arsenic and bubonic plague not the best recommendation.

The fact that people think its fine to take antidepressants everyday, yet find it wrong to use something that nature has provided for us just goes to show how brainwashed people are.

Very few people would think its fine to take antidepressants every day over long periods

Many folk think cannabis has its place in medicine. Indeed some of its uses are not really controversial anymore.

Yet some of the most successful musicians, artists, etc in history smoked weed religiously. You have no way to know if your friends would have turned out that way whether they smoked weed or not.

[url= http://www.guardian.co.uk/culture/2012/jan/26/22-minutes-with-lee-scratch-perry ]Lee 'Scratch' Perry: 'When I was a man, I was a cannibal'[/url]

A god, a hero, and a good example of what happens when you smoke a lot of ganja for many years

DrP
The point is that a lot of these substances are beneficial as they are, without being processed, however without being processed they do not generate funds for the scum bag organised drug dealers.

By all means develop the substances but why ignore them altogether simply becasue you cannot control their supply and make money from them.

Modern medicine has it's place, however it is influenced to an unhealthy degree by business.

aye one of the best things about the illegal drugs trade is the fact it has nothing to do with making money and all the particiapants are paragons of virtue just trying to help make the world a better place

another excellent point

Hahaha! junkyard.

That's not quite what I'm saying, I'm saying that individuals suffering from certain conditions are saying that consuming cannabis works for them and that people suffering from the same or similar conditions should be open to trying the substance and seeing for themselves if it works.

After all if we had listened to people like you all along, we wouldn't be using cannabis for MS sufferers, once apon a time the same rubbish your spouting now was also spouted about MS.

Stupid is as stupid does though and ignorance is bliss!

hahaha! junkyard you are a true comedian today!

Well done much better than your usual dull, bitter, sexually represed self I tells ya!

The drugs as you call them are herbal remedies, the only people who call them drugs are minions of stupidity, they are illegal because those who choose to use them are denied the right, we can drink excessivly, smoke nicotien, even breath in pollution every day of our lives, all of which will kill us in time and that's fine.

But if someone want to consume cannabis they are a drug taker and if someone wants to sell it they are a drug dealer.

hahahaha! keep them coming junkyard.

😯

Edited out as Kaesae edited the post I was replying to

TandemJeremy - Member

Edited out as Kaesae edited the post I was replying to

Sorry TJ enough sillyness for me I need to get back to work.

I will leave you with this thought though, a lot of research has been done into herbal remedies by the athletics bodies in relation to performance enhancement for athletes, so clinical studies exist for a lot of herbal remedies, that by the way countless millions of people use each year.

Why is it that so little research is being done by the established medical sector?

As has been stated a lot of medicines are made from herbal remedies, however research into the effectiveness of the remedies on thier own is almost non existent.

My advice to the OP is do not be limited by what modern medicine tells you is possible or the best course of treatment, research if for yourself and then try different approaches, if it works use it, if not then reject it.

As for cannabis or grass, I would invest in a vaporiser and use it every couple of days, give your body time without it or there is a good chance an immunity will be built up that will lead to necessity of increased doses.

Stupid is as stupid does though and ignorance is bliss!

Placebo means subjective reports are worthless.
nothing in your diatribe will ater this fact...it is not an effective methoid of assessing the efficacy of drugs.

In the example you cite clinical trials proved the efficacy not self reports.

ps if a herbal remedy actualy worked it would also be called a drug
calling me names will not make your argument any better

It's not called dope for nowt...

Ignoring the rights and wrongs, and going back to where the OP started it, just to be wary that, given that it's illegal and will be bought from criminals, the weed you buy may not be that "pure and natural" as, for example, it can have ground glass added to give that nice "shiny bud" look. As with food, grow your own and you'll know what you're getting....

😯 😀

STW bong olympics anyone? 😉

zippykona, if you are still here, don't just get her some skunk off some random dealer, it is pretty horrible stuff, too much THC in relation to other active compounds in it, and I'm not sure if people are still in the habit of cutting it with microscopic glass cleaning beads to make weight, they were a couple of years ago anyway. Try and find some nice mellow homegrown from a reputable source, and start small in terms of dose, especially if is being ingested, as with all drugs (including coffee!) it is no fun at all if you have too much.

I found a dooby after lunch very helpful when I was laid up after a bad bike vs car accident, maybe it doesn't work pharmacologically the same way as conventional painkillers, but when I had a broken bone and severe bruising, finding it very painful to move around, being a bit stoned took away a lot of the general background pain and took my mind off it all. It helped me sleep too, though I could still only manage 4 hours lying down before I had to get up.

[url= http://www.****/health/article-545408/Superskunk-What-happened-woman-smoked-dope-daily-month-BBC-documentary.html ]This[/url] is hilarious.

What a load of BS.

Actually, pharmaceutical companies are very much developing cannabinoid analgesics - some are already in clinical trials and well on their way to submission for approval.

Rachel

[i][b]Cannabinoid derivatives tested in cancer, chronic non-malignant or acute pain [u]proved no better than the least effective analgesics[/u], but with many adverse events, including psychotropic adverse events.[/b][/i]

http://www.medicine.ox.ac.uk/bandolier/booth/painpag/Chronrev/Analges/cannpain.html

Crikey that is seriously old, things have moved on since then. Sativex is on the verge of being licensed for cancer pain.

http://www.gwpharm.com/US%20Patent%20Granted%20for%20Sativex%20in%20Cancer%20Pain.aspx

Er, so Big Pharma, nasty exploitative Big Pharma, who have seen a gap in the market, are now selling you cannabinoids?

Can I bring my shirts round while you're ironing?

Er, so Big Pharma, nasty exploitative Big Pharma, who have seen a gap in the market, are now selling you cannabinoids?

Yeah more than one.

Flow nobody is telling you to stop smoking, but stop trying to believe and convince others that it's for anything other than your need to get high.
The article you posted is a genuine account of how an active motivated lady became mad and lazy after experimenting with a cannabis habit - you follow with "complete BS".
What's your point exactly? Why would she lie about it?

Hugor - did you read any of the CFS thread? flow simply refuses to beleive anything he does not want to hear.

Its pointless arguing with him.

...and my shirts?

As noted above; herbal medicine that works is called medicine...

When it is shown that cannabis or one of its derivatives is useful as an analgesic, it will become one of the many options we have for pain control. The blanket silliness of those who believe it's the best thing ever because it's 'natural' because 'nature gave it to us' is simply laughable.

The best all round analgesic we have is derived from the opium poppy; all natural, all given by nature, incredibly well researched, incredibly well understood in terms of pain theory and in terms of use...

...and an awful long way from 'get your mum stoned'..

Agree TJ - its hard to sit back sometimes and not react.

Tell me about it.

I think he's passed out now 😆

CBA to read the whole thread, but from my experiences (20 years of smoking cannabis), I can honestly say I've never experienced any painkilling properties.

In fact to the contrary - half the time it gave me pains I didn't know I had. At times I was psychologically dependant on it - i.e. not craving it in the same way as tobacco, but convinced I needed a 'smoke' nontheless.

I gave it up a while back due to a lot of the jobs I go on being subject to drug & alcohol tests. I don't miss it one bit - on reflection (and I knew this whilst I was smoking it), apart from enjoying being whacked out of my brains, it made me jittery, nervous, lazy, lethargic and paranoid.

My mates still smoke it, but now when I'm in their company I'm happy to avoid it, rather than crave it.

The best all round analgesic we have is derived from the opium poppy; all natural, all given by nature, incredibly well researched, incredibly well understood in terms of pain theory and in terms of use...

...and an awful long way from 'get your mum stoned'..

All large pharma companies will have / had a cannabanoid program, many of them for pain indications. The field took a huge knock over an anti-obesity drug called rimonabant, a cb1 antagonist. Tackling obesity at the CNS level is risky - if it had worked rimonabant would literally have been a household name and then some, as there was speculation that it could be used for any addictive behaviour (smoking, gambling etc). Sadly, manipulating the brain's reward system is a delicate business, and the drug was withdrawn with fatties reporting side-effects of severe depression and suicidal thoughts.

Indeedy...

I've used and experienced a goodly number; Fentanyl, Alfentanil, Remifentanil, Morphine, Diamorphine, Tramadol, Pethidine, Codeine and so on. All as medically prescribed analgesia or as an adjunct to sedation. They aren't perfect; they all have more or less of the well known opiate side effects, but they do work extremely well as analgesics.

I've also, in a previous life, had a large amount of cannabis in various forms, and I know which of the two I would choose if I was in pain.

Blimey.

Some stuff I've seen on programmes about this:

- Don't just buy any old dope off the street, you want mild old school weed not modern skunk
- Heavy use could precipitate paranoia and other mental problems in people [i]who were already susceptible[/i]
- There are tons of people using it for pain relief.

I'm surprised TJ is so anti. It's a mild and non addictive drug - if you try it a few times nothing bad will happen. It's not an analgesic, but neither is aspirin, is it?

I'm also amazed that people are pushing the 'it's natural' line. Here are some other natural things you might like to try, they must all be fine: opium, cocaine, magic mushrooms, peyote, cane toad juice, hemlock and curare.

And as has been said, pharmaceuticals cos are going through tribal medicines as fast as they can to see if there's anything they can make money from.

Molgrips - I am not anti cannabis - I am anti bad medical advice. It simply is not an analgesic / painkiller. It can have a place as an antispasmodic, as an adjunct in pain relief and in a few other ways

Its also a very powerful drug.

Heavy use could precipitate paranoia and other mental problems in people who were already susceptible

I do know a little about medicine, pain relief and cannabis. Flows advice is bad advice IMO - dangerously so.

I am anti bad medical advice

Me too, but that's not how I read the thread at all. And we know it's not an analgesic.

It seems to me (in my non medical limited experience) that it would be worth a try to someone in a desperate situation. Surely one spliff/brownie doesn't cause instant paranoia... does it?

Surely one spliff/brownie doesn't cause instant paranoia... does it?

I don't know.. what do you mean by that..?
Was that comment directed at me..?
Are you in on this..?
You're one of them aren't you..?

Where's Dave..?

molgrips - for example

flow - Member

"(tj) Cannabis is not a painkiller."

Yes it is.

and several other times Flow insisted it is.

My view is that the OP has not reached the end of the conventional road yet. FM is thought by many to be largely or wholly psychosomatic and linked with various mental health issues. Giving someone who may be vulnerable mentally cannabis is bad advice IMO.

And yes - one dose may well cause (reversable) paranoia

When I was much younger I smoked a fair amount

Surely painkiller and analgesic are not necessarily the same thing..?

The word analgesic derives from Greek an- ("without") and algos ("pain").

I find the first spliff gives me the worst paranoia - this then abates with further use. I'm not sure about long term effects, as I am a long term user - ergo, I have no idea how I would have turned out otherwise.

I am sometimes a bit paranoid and insecure, but whether I would have been this way otherwise, who knows?

Thanks for the Greek lesson TJ 🙄

TJ - if its not a pain killer, why is it being licensed for pain?

Also opium based pain killers are no doubt more effective, they are also highly addictive and a lot worse for you. Hardly something you can use long term.

It is also an analgesic so you are wrong again (I'm starting to see a pattern here)

Tetrahydrocannabinol (THC) and some other cannabinoids, either from the Cannabis sativa plant or synthetic, have analgesic properties, although the use of cannabis derivatives is currently illegal in many countries. A recent study finds that inhaled cannabis is effective in alleviating neuropathy and pain resulting from e.g. spinal injury and multiple sclerosis.

I haven't given any bad advice, I have shared my own experience, stated some facts, and shared some evidence.

You really are a strange chap.

THC is an analgesic in animal models of pain, and there's no doubt that the cannabinoid receptor is important in pain pathways. Away from the lab, though, controlled trials in humans have not been positive AFAIK, with no significant analgesia being observed. I'm far from an expert myself, mind - Do you know of any successful studies?

If you have access to the literature, one clearly negative study is described here: Pain. 2003 Sep;105(1-2):79-88.

That's taking THC under controlled conditions, as well. Smoking weed is a different story again.

Yeah smoking it is slightly different, there have been at least 85 cannabinoids isolated from the cannabis plant, restricting it to just THC is a bit, well, restrictive.

http://www.gwpharm.com/sativex.aspx

when I quit using cannabis I noticed a marked decrease in my pro cannabis evangelism.. 8)

indeed yunki indeed

Kaesae there was an interesting programme on Radio 4 this week that touched on some of the stuff you mention

http://www.bbc.co.uk/programmes/b01cjwtd

http://en.wikipedia.org/wiki/Cochrane_Collaboration

http://en.wikipedia.org/wiki/Iain_Chalmers

Sits some where between our views

Why do you think morphine, when used correctly, is addictive?

Do let me know, because it would seem you have some information/evidence that the medical profession is missing, and it might just change my practice dramatically....

DrP

Flow - you have given extremely bad advice. To suggest that someone who is probably mentally vulnerable should smoke cannabis is bad advice.

You have given no facts.

Painkiller and analgesic are synonyms

Cannabis is not an analgesic. It may have an effect on neuropathic pain. Same as it may have an antispasmodic effect and it may be a useful adjunct to analgesia in intractable and neuropathic pain. There is no analgesic effect however.

Also opium based pain killers are no doubt more effective, they are also highly addictive and a lot worse for you. Hardly something you can use long term.

Wrong. Long term usage of opiates has very little adverse effects. Unlike cannnabis

Long term usage of opiates has very little adverse effects

I see quite a few people in the city centre most days in a really bad way who would certainly prove that wrong!

AHAHAHAHAHHA!

So it isn't an analgesic, even though there is evidence to prove otherwise?

And you think opiate based drugs are safer to use long term than cannabinoids?

There are no [u][b]proven[/b][/u] long term side effects of using cannabis.

Keep them coming Dr TJ 😆

Why do you think morphine, when [b]used correctly[/b], is addictive?

DrP

Where is your evidence that it is an analgesic? You have been given several studies where it is shown not to be. Show me one decent study showing it to be an analgesic.

I know opiates are safer. This is why they are widely used. one of the safest drugs - far safer than paracetamol for example.

Why do you think morphine, when used correctly, is addictive?

DrP

Because it causes psychological and physical dependence, and tolerance.

Whats your point?

TJ

http://bjp.rcpsych.org/content/178/2/107.full

Cannabinoids are effective analgesics in animal models with non-opiate mechanisms predominating. There are many anecdotal reports (Grinspoon & Bakalar, 1993) of benefits in bone and joint pain, migraine, cancer pain, menstrual cramps and labour.

Five small RCTs (Table 3) show that THC is significantly superior to placebo and produces dose-related analgesia peaking at around 5 hours, comparable to but out-lasting that of codeine.

http://www.neurology.org/content/68/7/515.short

Results: Fifty patients completed the entire trial. Smoked cannabis reduced daily pain by 34% (median reduction; IQR = ?71, ?16) vs 17% (IQR = ?29, 8) with placebo (p = 0.03). Greater than 30% reduction in pain was reported by 52% in the cannabis group and by 24% in the placebo group (p = 0.04). The first cannabis cigarette reduced chronic pain by a median of 72% vs 15% with placebo (p < 0.001). Cannabis reduced experimentally induced hyperalgesia to both brush and von Frey hair stimuli (p ? 0.05) but appeared to have little effect on the painfulness of noxious heat stimulation. No serious adverse events were reported.

http://www.nature.com/npp/journal/v34/n3/full/npp2008120a.html

Pain reduction was significantly greater with cannabis compared to placebo (median difference in pain reduction=3.3 DDS points; effect size=0.60; p=0.016, all completers included; Figure 4). The results were consistent for the ITT analysis (p=0.020), and for the comparison based on the first week of treatment alone (median change in DDS pain =?4.1 and 0.1 for the cannabis and placebo arms, p=0.029). There were no evident sequence effects: the degree of pain relief achieved with active cannabis did not differ significantly according to whether it was administered during the first or the second treatment week (mean reduction in DDS points, 4.1 vs 0.96; p=0.13).

Flow 0

the first is a review - the studies referred to are small scale cannabis is used as an adjunct and becuses of this the data useless

teh remaining two are neuropathic pain where I have said it is known it has an effect.

None of those show cannabis as an analgesic.

Edit no side effects?

Five small RCTs (Table 3) show that THC is significantly superior to placebo and produces dose-related analgesia peaking at around 5 hours, comparable to but out-lasting that of codeine. Side-effects were also dose-related, and consisted of slurred speech, sedation and mental clouding, blurred vision, dizziness and ataxia. Levonantradol was also superior to placebo and notably long-acting, but almost half the patients reported sedation. Cannabinoids may have considerable potential in neuropathic pain (Institute of Medicine, 1999).

stoner dude argues with medical professionals about the effects of stoners dude recrational drug of choice

Its true kids drugs really do **** up your mental faculties 8)

TJ - find me some evidence it isn't an analgesic and we might get somewhere.

So far you haven't contributed to the thread at all, only disagreed.

Jusnkyard - TJ is as much of medical professional as I am a "stoner".

Ah, an interesting thread for once....

My experience, used ecstacy and speed all through the 90s rave scene....had some short term memory issues which reversed when i grew out of the scene and stopped using these drugs....also tried some mushroom and LSD trips on nice sunny days at college, fun but completely impractical for long term use....then played about with cocaine in my 20s when i was earning good money and hanging around with a dealer, no noticeable psychological side effects (that i noticed anyway)....also played about with Tramadol, very pleasant and more importantly legal which became a concern as i got older....

....one thing i have always shied away from though is cannabis use....unfortunately i've seen too many of my old ravey mates give up the 'chemicals' but continue smoking weed and to describe them as slow is an understatement....the crankiness if they didnt have a joint that morning is on a par with withdrawal from any other substance that becomes habit forming, the dulled stoned effect following a joint concerns me....some of them drive in this state which i cant abide by....but its ok, its natural they say.....seen enough people under 20 when i'm working custody duties who are literally shot away, when pressed on their drug use cannabis seems to be the common factor....in what bizarre way can anybody think that spending the day stoned is a good idea?....there will be negative side effects.
Part of the 'harmless' image of cannabis is that it is smoked (socially acceptable) and its natural....as others have said; heroin is natural, so is alcohol....they are also devastating if abused....the 'natural' argument is clutching at straws....most meds in the BNF are naturally occuring too....would cannabis users be so quick to defend the drug if it had to be intravenously injected?
Most stereotypes are stereotypes for a good reason....spending time with stoners is boring, its like being around somebody who is pissed all the time....painful and frustrating.

If you want better pain relief look at combinations of known, researched drugs....stacking things like Paracetamol, Ibuprofen and an Opioid together will often have a better effect than high doses of a singular drug.

(in my experience ecstacy used to shift a cold too....or it could have been the 12 hours in a club drinking massive amounts of water and sweating like a sprinkler....who knows?....best to pop some E's next time i've got a cold though eh?.... :lol:)

usnkyard - TJ is as much of medical professional as I am a "stoner".

You have been given several references to negative studies.

I am a registered nurse with decades of experience and a fair few qualifications including post graduate courses in pain control.

My sister is a nurse of 20 years, she knows no more than me about FS/ME/FM, let alone the effects of cannabbinoids on pain.

Its hardy something a nurse would study in depth.

You have been given several references to negative studies.

Errr, you haven't contributed anything, as usual.

Flow.. mate

I'm quite a supporter of the movement for therapeutic cannabis use to be taken more seriously..

as far as I can see you're not really helping.. 😕

Your right, I'm probably not. TJ has bored me to death as usual, I don't know why I let myself get drawn into his factless debates.

Flow.

Your sister hasnt chosen to specialise in those areas then has she?

A nurse working in a pain clinic, hospice or for one of the cancer services (marie curie, macmillan etc) will know more about the subject of pain than a nurse in a ward for example.
Most NHS trusts will sponsor further education for staff if the course being requested is relevant to the job being done....just because your sister hasnt undertaken post graduate study into pain management does not mean that TJ hasnt, not all nurses do the same job, work in the same areas, have the same skills or need the same knowledge.