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  • by Paul Armentano, NORML Deputy Director March 22, 2016

    cannabis_pillsChronic pain patients with legal access to medicinal cannabis significantly decrease their use of opioids, according to data published online ahead of print in The Journal of Pain.

    Investigators at the University of Michigan, Ann Arbor conducted a retrospective survey of 244 chronic pain patients. All of the subjects in the survey were qualified under Michigan law to consume medicinal cannabis and frequented an area dispensary to obtain it.

    Authors reported that respondents often substituted cannabis for opiates and that many rated marijuana to be more effective.

    “Among study participants, medical cannabis use was associated with a 64% decrease in opioid use, decreased number and side effects of medications, and an improved quality of life,” they concluded. “This study suggests that many chronic pain patients are essentially substituting medical cannabis for opioids and other medications for chronic pain treatment, and finding the benefit and side effect profile of cannabis to be greater than these other classes of medications.”

    About 40 people die daily from opioid overdoses, according to the US Centers for Disease Control.

    Clinical trial data published last month in The Clinical Journal of Pain reported that daily, long-term herbal cannabis treatment is associated with improved pain relief, sleep and quality of life outcomes, as well as reduced opioid use, in patients unresponsive to conventional analgesic therapies.

    The results of a 2015 Canadian trial similarly concluded that chronic pain patients who consumed herbal cannabis daily for one-year experienced reduced discomfort and increased quality of life compared to controls, and did not possess an increased risk of serious side effects.

    Separate data published in 2014 in The Journal of the American Medical Association determined that states with medical marijuana laws experience far fewer opiate-related deaths than do states that prohibit the plant. Investigators from the RAND Corporation reported similar findings in 2015, concluding, “States permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.” Clinical data published in 2011 in the journal Clinical Pharmacology & Therapeutics previously reported that the administration of vaporized cannabis “safely augments the analgesic effect of opioids.”

    An abstract of the University of Michigan study, “Medical cannabis associated with decreased opiate medication use in retrospective cross-sectional survey of chronic pain patients,” appears online here.

  • by Paul Armentano, NORML Deputy Director February 22, 2016

    for_painThe long-term, daily use of cannabis is associated with improved analgesia and reduced opioid use in patients with treatment-resistant chronic pain conditions, according to clinical trial data reported online ahead of print in The Clinical Journal of Pain.

    Investigators with Hebrew University in Israel evaluated the use of cannabis on pain in a cohort of 176 patients, each of whom had been previously unresponsive to all conventional pain medications. Subjects inhaled THC-dominant cannabis daily (up to 20 grams per month) for a period of at least six months.

    A majority of participants (66 percent) experienced improvement in their pain symptom scores after cannabis therapy, and most reported “robust” improvements in their quality of life. Subjects’ overall consumption of opioid drugs declined 44 percent by the end of the trial, and a significant percentage of participants discontinued opioid therapy altogether over the course of the study.

    Authors concluded, “In summary, this long-term prospective cohort suggests that cannabis treatment in a mixed group of patients with treatment-resistant chronic pain may result in improved pain, sleep and quality of life outcomes, as well as reduced opioid use.”

    The Israeli results are similar to those reported in a 2015 Canadian trial which concluded that chronic pain patients who use herbal cannabis daily for one-year experienced reduced discomfort and increased quality of life compared to controls, and did not possess an increased risk of serious side effects.

    According to data published in 2014 in The Journal of the American Medical Association, US states with medical marijuana laws experience far fewer opiate-related deaths than do states that prohibit the plant. Investigators from the RAND Corporation and the University of California, Irvine reported similar findings in 2015, concluding, “States permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.” Clinical data published in 2011 in the journal Clinical Pharmacology & Therapeutics previously reported that the administration of vaporized cannabis “safely augments the analgesic effect of opioids.”

    A review published earlier this year in the Canadian Journal of Anesthesia assessing the clinical use of cannabinoids for pain in over 1,300 subjects concludes, “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.”

    An abstract of the study, “The effect of medicinal cannabis on pain and quality of life outcomes in chronic pain: A prospective open-label study,” appears online here.

  • by Paul Armentano, NORML Deputy Director February 9, 2016

    cannabis_pillsCannabinoids 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.

  • by Paul Armentano, NORML Deputy Director November 17, 2015

    pain_reliefCannabinoids 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.

  • by Paul Armentano, NORML Deputy Director September 21, 2015

    Chronic pain patients who use herbal cannabis daily for one-year report reduced discomfort and increased quality of life compared to controls, and do not experience an increased risk of serious side effects, according to clinical data published online ahead of print in the Journal of Pain.

    Researchers at McGill University in Montreal assessed the long-term health of 216 medicinal cannabis users with chronic non-cancer pain who consumed a daily standardized dose (12.5 percent THC) of herbal cannabis compared to 215 controls (chronic pain suffers who did not use cannabis). Subjects in study were approved by Health Canada to legally use medicinal cannabis and consumed, on average, 2.5 grams of herb per day, typically via inhalation or vaporization.

    Investigators reported that daily cannabis consumers possessed no greater risk than non-users to experience “serious adverse events.” Specifically, researchers identified no significant adverse changes in consumers’ cognitive skills, pulmonary function, or blood work following one-year of daily cannabis consumption. Medical cannabis consumers did report elevated risk of experiencing “non-serious adverse events” (e.g., cough, dizziness, paranoia) compared to controls; however, authors classified these to be “mild to moderate.”

    Pain patients who used cannabis reported a reduced sense of pain compared to controls, as well as reduced anxiety, depression, and fatigue.

    “Quality-controlled herbal cannabis, when used by cannabis-experienced patients as part of a monitored treatment program over one year, appears to have a reasonable safety profile,” authors concluded.

    The study is one of the first to ever assess the long-term safety and efficacy of medicinal cannabis. A prior health review of patients receiving medical cannabis monthly from the US federal government as part of the Compassionate Investigational New Drug program similarly reported that cannabis possesses therapeutic efficacy and an acceptable side-effect profile.

    Full text of the study, “Cannabis for the Management of Pain: Assessment of Safety Study,” appears online here.

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