Vaporized cannabis mitigates pain intensity in diabetic subjects in a dose-dependent manner, according to clinical trial data published online ahead of print in The Journal of Pain.
Investigators at the University of California, San Diego assessed the efficacy of inhaled cannabis versus placebo in 16 patients with painful diabetic peripheral neuropathy (DPN).
Authors reported: “This small, short-term, placebo-controlled trial of inhaled cannabis demonstrated a dose-dependent reduction in diabetic peripheral neuropathy pain in patients with treatment-refractory pain. … Overall, our finding of an analgesic effect of cannabis is consistent with other trials of cannabis in diverse neuropathic pain syndromes.”
A series of clinical trials conducted by investigators affiliated with the Center for Medicinal Cannabis Research at the University of California, San Diego previously reported that the inhalation of whole-plant cannabis is efficacious in the treatment of various types of treatment-resistant neuropathic pain, including HIV-associated neuropathy and spinal cord injury. According to the findings of a 2014 clinical trial published in the Journal of Pain and Palliative Care Pharmacotherapy, “At least 10 randomized controlled trials, lasting for more than 1000 patients, have demonstrated efficacy of different types of cannabinoids for diverse forms of neuropathic pain.”
An abstract of the study, “Efficacy of inhaled cannabis on painful diabetic neuropathy,” appears online here.
State Public Health Department officials have recommended over $7 million dollars in grant funding to pay for a series of state-sponsored clinical trials to assess the safety and efficacy of cannabis and cannabinoids.
The proposed studies include a pair of clinical trials to evaluate the use of cannabidiol (CBD), a nonpsychotropic plant cannabinoid, for patients with pediatric epilepsy. Two additional trials will assess the use of cannabis for patients suffering from post-traumatic stress. Other studies will assess the efficacy of either cannabis or CBD in the treatment of Parkinson’s disease, brain tumors, ulcerative colitis, and pain management. (More specific summaries of all eight proposed studies are available online here.)
Grant funding for the proposed studies requires final approval by the state Board of Health in December.
Following funding approval, researchers will still be required to gain additional federal approval in order to obtain access to research-grade cannabis or CBD.
The state of California previously sponsored a similar series of clinical trials assessing the safety and efficacy of marijuana. Those studies evaluated the use of whole-plant cannabis in patients with neuropathy, multiple sclerosis, and autoimmune deficiencies. A summary of those trials, published in 2012, concluded, “Based on evidence currently available the Schedule I classification is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking.”
As I wrote last week in an op/ed for The Sacramento Bee, when it comes to the federal government’s policy on marijuana, not so much.
Viewpoints: Science supporting medicinal pot is clear
via The Sacramento Bee
A dozen years ago, California lawmakers did something extraordinary. They authorized investigators throughout California to conduct a series of FDA-approved, gold standard trials to assess whether cannabis is safe and effective as a medicine.
In all, researchers conducted more than a dozen clinical studies examining whether cannabis could meet objective standards of safety and therapeutic efficacy. For example, investigators at the University of California, San Francisco, assessed whether vaporizing cannabis could rapidly and consistently deliver the plant’s active ingredients to patients in a manner that is far safer than smoking. It could. At UC San Diego, clinicians examined whether inhaling cannabis posed potential harms to the immune system, particularly in subjects suffering from immune-compromised conditions like HIV. It didn’t. And at universities throughout the state, investigators studied whether marijuana provided statistically significant relief in a number of hard-to-treat conditions, such as multiple sclerosis and neuropathic (nerve) pain. Cannabis did so – consistently.
… Nonetheless, policymakers – particularly those in Washington – have responded to these most recent scientific findings with no more than a collective yawn. Despite pledging to let “science and the scientific process … inform and guide decisions of my administration,” neither President Barack Obama nor Congress have taken any steps to amend federal law or federal policy to reflect the scientific reality that marijuana possesses well-established therapeutic value. In fact, this administration has taken just the opposite approach.
In 2011, the Obama administration quashed out-of-hand an administrative petition that sought federal hearings regarding the present classification of cannabis as a substance with “no currently accepted medical use in treatment in the United States.” In its rejection, the administration alleged, “The drug’s chemistry is not known and reproducible; there are no adequate safety studies; there are no adequate and well-controlled studies proving efficacy; the drug is not accepted by qualified experts; and the scientific evidence is not widely available.”
Yet, the findings from California’s 12-year-old study program show that each of these claims is demonstrably false.
It is long past time to reject the notion that we as a society possess insufficient evidence regarding the safety and efficacy of cannabis. The truth is that we know plenty. Most of all we know that there remains no valid scientific reason to justify the continued targeting, prosecution and incarceration of those Americans who consume cannabis responsibly.
Read my entire commentary here.
Is it any wonder that the US government fights tooth-and-nail to hinder researchers’ attempts to conduct clinical trials assessing the therapeutic utility of cannabis as a medicine? After all, each and every time the federal government begrudgingly allows for such studies they’re faced with credibility-shattering results like this:
Marijuana relieves muscles tightness, pain of multiple sclerosis: Study
via the Toronto Star
Smoking marijuana can relieve muscle tightness, spasticity (contractions) and pain often experienced by those with multiple sclerosis, says research out of the University of California, San Diego School of Medicine.
The findings, just published in the Canadian Medical Association Journal, included a controlled trial with 30 participants to understand whether inhaled cannabis would help complicated cases where existing pharmaceuticals are ineffective or trigger adverse side effects.
MS is an unpredictable, often disabling disease of the central nervous system, which is made up of the brain and spinal cord.
The disease attacks the myelin, the protective covering wrapped around the nerves of the central nervous system, and — among other symptoms — can cause loss of balance, impaired speech, extreme fatigue, double vision and paralysis.
The average age of the research participants was 50 years with 63 per cent of the study population female.
More than half the participants needed walking aids and 20 per cent used wheelchairs.
Rather than rely on self-reporting by patients regarding their muscle spasticity — a subjective measure — health professionals rated each patient’s joints on the modified Ashworth scale, a common objective tool to evaluate intensity of muscle tone.
The researchers found that the individuals in the group that smoked cannabis experienced an almost one-third decrease on the Ashworth scale — 2.74 points from a baseline score of 9.3 — meaning spasticity improved, compared to the placebo group.
As well, pain scores decreased by about 50 per cent.
“We saw a beneficial effect of smoked cannabis on treatment-resistant spasticity and pain associated with multiple sclerosis among our participants,” says Dr. Jody Corey-Bloom of the university’s department of neuroscience.
To those familiar with medicinal cannabis research, the results are hardly surprising. After all, Sativex — an oral spray containing plant cannabis extracts — is already legal by prescription to treat MS-related symptoms in over a dozen countries, including Canada, Germany, Great Britain, New Zealand, and Spain. Further, long-term assessments of the drug indicate that in addition to symptom management, cannabinoids may also play a role in halting the course of the disease.
Nevertheless, the National MS Society — like the US government — shares little enthusiasm for cannabis medicine, stating, “Studies completed thus far have not provided convincing evidence that marijuana or its derivatives provide substantiated benefits for symptoms of MS.”
Patient advocacy organizations, like the MS Society, have a responsibility to represent the interests of their constituents and to advise practitioners regarding best treatment practices. Why then does this responsibility not extend to patients who use cannabis as an alternative treatment therapy or to those that might one day potentially benefit from its use?
[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.