Neuropathic pain: Smoking Cannabis Reduces Pain, H | Arthritis Information
Smoking Cannabis Reduces Pain, Helps Sleep And Improves Mood For Those With Chronic Symptoms
30 Aug 2010
For patients with chronic (long-term) neuropathic pain, smoking
cannabis was found to reduce symptoms of pain, improve mood and help
sleep, a report published in
CMAJ (Canadian Medical Journal
Association) revealed. When damage or dysfunction of the nervous system
results in chronic neuropathic pain, patients have few treatment
options, such as antidepressants, local anesthetics, anticonvulsants or
opioids. However, these medications often have undesirable side effects
and do not work for everybody.
The authors inform that oral cannabinoids have been effective in
reducing the symptoms of some types of pain. However, they many have
different effects and risks compared to smoked cannabis.
Investigators from McGill University Health Centre (MUHC) and McGill
University carried out a randomized, controlled trial to determine the
analgesic effect of smoked cannabis in 21 patients, aged 18 years or
more, all of them with chronic neuropathic pain. THC levels (drug
potencies) were divided into 2.5%, 6% and 9.4%. Some participants also
received a placebo (0%).
The researchers inform that there was a correlation between increased
THC content and better sleep quality. Symptoms of depression and/or
anxiety were also reduced at 9.5% THC level.
Lead author Dr. Mark Ware, Director of Clinical Research at the Alan Edwards Pain Management Unit of the MUHC, said:
We found that 25 mg herbal cannabis with 9.4% THC, administered as a
single smoked inhalation three times daily for five days, significantly
reduces average pain intensity compared with a 0% THC cannabis placebo
in adult subjects with chronic post traumatic/post surgical neuropathic
pain. We found statistically significant improvements in measures of
sleep quality and anxiety.
The authors believe their study is the
"first outpatient clinical trial of smoked cannabis ever reported."
As there have not been many studies on smoked cannabis for neuropathic
pain, the investigators say there should be further, longer-lasting
trials with higher THC potencies. Long-term safety studies of smoked
cannabis for medical purposes are also needed, they added.
Dr. Henry McQuay of Balliol College, Oxford University, UK, writes in a related Commentary:
The authors should be congratulated for tackling such a worthwhile
question as: does cannabis relieve neuropathic pain?, particularly
because the trial must have been a major nightmare to get through the
various regulatory hurdles. What makes it a worthwhile question is the
continuing publicity that patients see, hear and read, suggesting
analgesic activity of cannabis in neuropathic pain, and the paucity of
robust evidence." He concludes that "this trial adds to the trickle of
evidence that cannabis may help some of the patients who are struggling
at present.
"Smoked cannabis for chronic neuropathic pain: a randomized controlled trial"
Mark A. Ware, Tongtong Wang, Stan Shapiro, Ann Robinson, Thierry
Ducruet, Thao Huynh, Ann Gamsa, Gary J. Bennett, Jean-Paul Collet
Published online ahead of print August 30, 2010
CMAJ 10.1503/cmaj.091414
Commentary:
"More evidence cannabis can help in neuropathic pain"
Henry J. McQuay
Published online ahead of print August 30, 2010
CMAJ 10.1503/cmaj.100799
Written by Christian Nordqvist
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