Inhaled Marijuana ‘Clearly Has Medical Value’ For Hard to Treat Chronic Pain Conditions

[Editor's note: This post is excerpted from this week's forthcoming NORML weekly media advisory. To have NORML's media advisories delivered straight to your in-box, sign up for NORML's free e-zine here.]

Inhaled cannabis reduces pain and improves sleep compared to placebo, and is well tolerated by patients with chronic neuropathy, according to clinical trial data published this week in the Journal of the Canadian Medical Association (CMAJ).

Investigators at McGill University in Montreal assessed the efficacy of inhaled cannabis on pain intensity in 23 subjects with chronic post-traumatic or post-surgical neuropathic pain in a randomized, double-blind, placebo-controlled crossover trial. Participants in the study received a single inhalation of 25 mg of 9.4 percent herbal cannabis or placebo three times daily. All of the volunteers in the study suffered from refractory pain for which conventional therapies had proven ineffective.

Researchers reported: “[H]erbal cannabis … significantly reduced average pain scores compared with … cannabis placebo in adult participants. … We found significant improvement in measures of sleep quality and anxiety. … Our results support the claim that smoked cannabis reduces pain, improves mood, and helps sleep.”

Speaking to Web MD online, the study’s lead researcher Mark Ware said: “We’ve shown again that cannabis is an analgesic. Clearly it has medical value.”

In February, investigators from the California Center for Medicinal Cannabis Research summarized the results of four separate FDA ‘gold standard’ designed clinical trials demonstrating that inhaled marijuana was safe and effective for the treatment of neuropathy.

An estimated one to two percent of the population suffers from some form of neuropathic pain, which typically goes untreated by standard analgesics.

Listen to NORML Executive Director Allen St. Pierre and NORML Advisory Board member Lester Grinspoon discuss this trial, and other subjects related to the medical use of cannabis, on NPR’s The Diane Rehm show here.

Over 2,500 Subjects Since 2005 Have Used Marijuana-Based Medicines In Controlled Clinical Trials

[Editor's note: This post is excerpted from this week's forthcoming NORML weekly media advisory. To have NORML's media advisories delivered straight to your in-box, sign up for NORML's free e-zine here.]

Researchers worldwide have performed 37 separate clinical trials assessing the therapeutic safety and efficacy of inhaled cannabis and marijuana-based medicines since 2005, according to a review published online last week in the journal Cannabinoids: The Journal of the International Association for Cannabinoid Medicines (IACM).

Investigators from Leiden University in the Netherlands and the nova-Institut in Germany conducted a systematic review of recent clinical trial data pertaining to the medical use of whole smoked marijuana and cannabinoids.

Authors identified 37 controlled studies since 2005 evaluating the therapeutic effects of cannabinoids. The trials involved a total of 2,563 subjects.

Of the 37 clinical trials that have been recently conducted, eleven assessed the drug’s impact on chronic neuropathic pain – a difficult to treat type of pain resulting from nerve damage. Other studies assessed the efficacy of cannabinoids to treat multiple sclerosis-associated spasticity (nine separate studies); HIV/AIDS (four); experimental pain (four); intestinal dysfunction (two); nausea/vomiting/appetite (two); schizophrenia (two); glaucoma (one); and ‘other indications (two).

Authors concluded, “Based on the clinical results, cannabinoids present an interesting therapeutic potential mainly as analgesics in chronic neuropathic pain, appetite stimulants in debilitating diseases (cancer and AIDS), as well as in the treatment of multiple sclerosis.”

Last Wednesday investigators from the California Center for Medicinal Cannabis Research released the results of a series of double-blind, placebo-controlled trials that determined that cannabinoids could be “a first-line treatment” for patients suffering from neuropathy.

Commenting on the review, NORML Deputy Director Paul Armentano said: “The safety and efficacy of marijuana as a medicine has now been established by the ‘gold standard’ of clinical study. Further, over 2,500 patients have used cannabinoids in controlled clinical trials over the past five years alone. This is a far greater total than the number of subjects that would likely be administered any other new drug pending United States FDA approval, and is a large enough population to once and for all establish marijuana’s objective value as a medicine.”

‘Gold Standard’ Studies Show That Inhaled Marijuana Is Medically Safe And Effective

The results of a series of randomized, placebo-controlled clinical trials assessing the efficacy of inhaled marijuana consistently show that cannabis holds therapeutic value comparable to conventional medications, according to the findings of a 24-page report issued earlier today to the California state legislature by the California Center for Medicinal Cannabis Research (CMCR).

Four of the five placebo-controlled trials demonstrated that marijuana significantly alleviated neuropathy, a difficult to treat type of pain resulting from nerve damage.

“There is good evidence now that cannabinoids (the active compounds in the marijuana plant) may be either an adjunct or a first-line treatment for … neuropathy,” said Dr. Igor Grant, Director of the CMCR, at a news conference at the state Capitol.  He added that the efficacy of smoked marijuana was “very consistent,” and that its pain-relieving effects were “comparable to the better existing treatments” presently available by prescription.

A fifth study showed that smoked cannabis reduced the spasticity associated with multiple sclerosis.  A separate study conducted by the CMCR established that the vaporization of cannabis – a process that heats the substance to a temperature where active cannabinoid vapors form, but below the point of combustion – is a “safe and effective” delivery mode for patients who desire the rapid onset of action associated with inhalation while avoiding the respiratory risks of smoking.

Two additional clinical trials remain ongoing.

The CMCR program was founded in 2000 following an $8.7 million appropriation from the California state legislature.  The studies are some of the first placebo-controlled clinical trials to assess the safety and efficacy of inhaled cannabis as a medicine to take place in over two decades.

Placebo-controlled clinical crossover trials are considered to be the ‘gold standard’ method for assessing the efficacy of drugs under the US FDA-approval process.

“These scientists created an unparalleled program of systematic research, focused on science-based answers rather than political or social beliefs,” said former California Senator John Vasconcellos, who sponsored the legislation in 1999 to launch the CMCR.  Vasconcellos called the studies’ design “state of art,” and suggested that the CMCR’s findings “ought to settle the issue” of whether or not medical marijuana is a safe and effective medical treatment for patients.

“This (report) confirms all of the anecdotal evidence – how lives have been saved and pain has been eased,” said California Democrat Senator Mark Leno at the press conference.  “Now we have the science to prove it.”

Full text of the CMCR’s report to the California legislature is available at online at: http://www.cmcr.ucsd.edu/CMCR_REPORT_FEB17.pdf.

Reuters: “Low Dose Pot Eases Pain While Keeping Mind Clear”

A funny thing happens when the US government begrudgingly allows for double-blind, placebo-controlled clinical trials evaluating the therapeutic efficacy of inhaled cannabis.  

Investigators discover time after time that it works! 

Here are the results from the latest study, conducted at California’s Center for Medical Cannabis Research.   

Low-dose pot eases pain while keeping mind clear
via Reuters News Wire

NEW YORK (Reuters Health) — Giving carefully calibrated doses of smoked marijuana to people with neuropathic pain, which can be difficult-to-treat and extremely painful, can ease their pain without clouding their minds, California researchers report.

Read the full story here. 

Unfortunately, according to recently released legal filings, fewer than 20 investigators in the United States currently possess federal approval to conduct legal clinical research on whole smoked cannabis. (Not surprisingly, most of these researchers are conducting trials that seek to assess the potential physical and mental harms allegedly associated with the drug.) In addition, state funding for the CMCR — which has backed virtually all of the medical cannabis research conducted over the past several years — has dried up and no new appropriations are likely.

Of course, federal officials could readily step in with grant money to keep this important clinical research going — after all, just last month the US National Institute on Drug Abuse announced that it would be spending millions to establish the first-ever ‘Center on Cannabis Addiction‘ — but, needless to say, I’m not holding my breath.