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.
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.
NORML is pleased to present the latest expanded/updated edition of the publication Emerging Clinical Applications for Cannabis & Cannabinoids — a comprehensive review of the latest peer-reviewed science specific to the safety and therapeutic efficacy of whole-plant cannabis and/or its components.
The 2015 updated edition includes two additional disease profiles (Parkinson’s disease and PTS) and includes summaries of an additional 50+ relevant clinical and/or preclinical trials specific to cannabinoids’ therapeutic utility. Several existing sections, such as Chronic Pain, Diabetes, and Epilepsy, have been significantly expanded since the last edition (January 2013). Also updated is the Introduction to the Endocannabinoid System (authored by Dustin Sulak, DO) and Why I Recommend Medical Cannabis (authored by Estelle Goldstein, MD).
With summaries and citations of well over 250 recent peer-reviewed studies, this updated publication is one of the most thorough and up-to-date source-books available specific to documenting the established therapeutic qualities of cannabis. The updated publication is available online here.
Individual sections of this publication may be accessed at the links below:
Introduction to the Endocannabinoid System
Why I Recommend Medical Cannabis
Amyotrophic Lateral Sclerosis
Human Immunodeficiency Virus
Methicillin-resistant Staphyloccus aureus (MRSA)
States that permit qualified patients to access medical marijuana via dispensaries possess lower rates of opioid addiction and overdose deaths, according to a study published by the National Bureau of Economic Research, a non-partisan think-tank.
Researchers from the RAND Corporation and the University of California, Irvine assessed the impact of medical marijuana laws on problematic opioid use, as measured by treatment admissions for opioid pain reliever addiction (compiled from the years 1992 to 2012) and by state-level opioid overdose deaths (compiled from the years 1999 to 2013).
“[S]tates permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not,” authors reported. They found that women over the age of 40 showed the most significant decrease in problematic opioid use.
Data published last year in the Journal of the American Medical Association (JAMA) Internal Medicine reported that the enactment of statewide medicinal marijuana laws is associated with significantly lower state-level opioid overdose mortality rates. “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws,” investigators reported.
Overdose deaths involving opioid analgesics have increased dramatically over the past decade. While fewer than 4,100 opiate-induced fatalities were reported for the year 1999, by 2010 this figure rose to over 16,600 according to an analysis by the US Centers for Disease Control.
An abstract of the study, “Do Medical Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers?”, is available 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.