Cannabinoids are safe and effective in the treatment of chronic pain conditions, according to a review of recent clinical trials published online ahead of print in the Canadian Journal of Anesthesia.
Investigators at the University of Montreal, Department of Anesthesiology evaluated the results of 26 clinical trials “of good or excellent quality” involving 1,364 subjects. Trials assessed the use of various types of cannabinoid preparations, including herbal cannabis, liquid and oral cannabis extracts, and synthetic cannabinoid agents in pain treatment.
Authors reported that cannabinoids were efficacious in alleviating various types of pain, including pain due to neuropathy, musculoskeletal disorders, fibromyalgia, HIV, and other chronic pain conditions.
They concluded, “Overall, the recent literature supports the idea that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain and possibly cancer-related pain.”
Their conclusion mimics that of a 2015 systematic review published in the Journal of Neuroimmune Pharmacology that reported, “[C]annabinoids are safe, demonstrate a modest analgesic effect, and provide a reasonable treatment option for treatment of chronic non-cancer pain.”
An abstract of the study, “Medical cannabis: considerations for the anesthesiologist and pain physician,” appears online here.
Cannabinoids are safe and effective for the treatment of chronic pain, according to the results of a systematic review of randomized controlled trials published in the Journal of Neuroimmune Pharmacology.
Investigators from Dalhousie University in Halifax, Nova Scotia and McGill University in Montreal evaluated the results of 11 placebo-controlled trials conducted between the years 2010 and 2014. Trials assessed the use of various types of cannabinoid preparations, including herbal cannabis, liquid and oral cannabis extracts, and nabilone (a synthetic analog of THC), in pain treatment.
Cannabinoids possessed “significant analgesic effects” and were “well tolerated” in the majority of studies reviewed.
Authors concluded, “The current systematic review provides further support that cannabinoids are safe, demonstrate a modest analgesic effect and provide a reasonable treatment option for treatment chronic non-cancer pain.”
A 2011 review of 18 separate randomized trials evaluating the safety and efficacy of cannabinoids for pain management similarly reported, “[C]annabinoids are a modestly effective and safe treatment option for chronic non-cancer (predominantly neuropathic) pain.”
In September, Canadian researchers reported that pain patients who consumed herbal cannabis daily for one-year experienced decreased analgesia and no increase in serious adverse side effects compared to matched controls.
An abstract of the study, “Cannabinoids for the treatment of chronic non-cancer pain: An updated systematic review of randomized controlled trials,” appears online here.
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.
The administration of a single dose of whole-plant cannabis via a thermal-metered inhaler is effective and well tolerated among patients suffering from neuropathy (nerve pain), according to clinical trial data published online ahead of print in the Journal of Pain and Palliative Care Pharmacotherapy.
Israeli investigators assessed the efficacy of a novel, portable metered-dose cannabis inhaler in eight subjects diagnosed with chronic neuropathic pain. Researchers reported that the device administered an efficient, consistent, and therapeutically effective dosage of cannabinoids to all participants.
They concluded, “This trial suggests the potential use of the Syqe Inhaler device as a smokeless delivery system of medicinal cannabis, producing a delta-9-THC pharmacokinetic profile with low inter-individual variation of (maximum drug/plasma concentrations), achieving pharmaceutical standards for inhaled drugs.”
A series of clinical trials conducted by investigators affiliated with the Center for Medicinal Cannabis Research at the University of California, San Diego previously determined that the inhalation of whole-plant cannabis is efficacious in the treatment of neuropathic pain.
Full text of the study, “The pharmacokinetics, efficacy, safety, and ease of use of a novel portable metered-dose cannabis inhaler in patients with chronic neuropathic pain: A phase 1a study,” will appear in the Journal of Pain and Palliative Care Pharmacotherapy.
The administration of synthetic cannabinoid agonists limits HIV infection in macrophages (white blood cells that aid in the body’s immune response), according to preclinical data published in the Journal of Leukocyte Biology. Macrophages are one of the first type of cells infected by the HIV virus when it enters the body.
Investigators at Temple University School of Medicine in Philadelphia assessed the impact of three commercially available synthetic THC agonists on HIV-infected macrophage cells. Following administration, researchers sampled the cells periodically to measure the activity of an enzyme called reverse transcriptase (RT), which is essential for HIV replication. By day 7, investigators reported that the administration of all three compounds was associated with a significant decreased in HIV replication.
Stated a Temple University Health System press release: “The results suggest that selective CB2 (cannabinoid 2 receptor) agonists could potentially be used in tandem with existing antiretroviral drugs, opening the door to the generation of new drug therapies for HIV/AIDS. The data also support the idea that the human immune system could be leveraged to fight HIV infection.”
Patients living with HIV/AIDS frequently report consuming cannabis to counter symptoms of anxiety, appetite loss, chronic pain, and nausea, and one study has reported that patients who use cannabis therapeutically are 3.3 times more likely to adhere to their antiretroviral therapy regimens than non-cannabis users. In preclinical models, the long-term administration of delta-9-THC has recently been associated with decreased mortality and ameliorated disease progression in monkeys. In clinical models, cannabis inhalation is associated with decreased neuropathy and increased levels of appetite hormones in the blood of subjects with HIV infection.
The abstract of the study, “Attenuation of HIV-1 replication in macrophages by cannabinoid receptor 2 agonists,” appears online here.