Chronic Pain
Medicinal Cannabis for Australian Patients with Chronic Refractory Pain Including Arthritis
Elise A. Schubert, Masego T. Johnstone and Nial J. Wheate (December 2022)
The overall chronic pain cohort, and specifically the balanced CBD:THC products, were associated with significantly reduced pain intensity scores (p = 0.003, p = 0.025), with 22% of patients reporting a clinically meaningful reduction in pain intensity. Patients in the arthritis subset (n = 199) reported significantly reduced pain intensity scores (p = 0.005) overall, and specifically for those taking CBD-only (p = 0.018) and balanced products (p = 0.005). Other HRQoL outcomes, including pain interference and pain impact scores were significantly improved depending on the CBD:THC ratio. Products that contained a balanced ratio of CBD:THC were associated with improvements in the most number of PROMIS-29 domains. Approximately half (n = 364; 51%) of the chronic pain cohort experienced at least one AE, the most common being dry mouth (24%), somnolence (19%) or fatigue (12%). These findings were similar in the arthritis subset.
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Safety and Effectiveness of Cannabinoids to Danish Patients with Treatment Refractory Chronic Pain — A Retrospective Observational Real-World Study
Tina Horsted, Karoline Lichon Hesthaven, Peter Derek Christian Leutscher (November 2022)
The findings in this retrospective study conducted in a real-world clinical setting suggest a favourable safety profile of cannabinoids. Moreover, one-sixth (intention-to-treat) and one-third (per-protocol) of patients with chronic pain refractory to conventional analgesics, or experiencing intolerable adverse effects, benefited significantly from therapy with oral cannabinoid regimens. Combination of THC and CBD seems overall more effective than cannabinoid monotherapy.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Medical Cannabis Use and Inflammatory Cytokines and Chemokines Among Adult Chronic Pain Patients
Prabjit Ajrawat, Yi Yang, Ewa Wasilewski, Timothy Leroux, Karim S. Ladha, Anuj Bhatia, Mandeep Singh, Sonalben Thaker, Mohit Kapoor, Andrea D. Furlan, Lakshmi P. Kotra, and Hance Clarke (November 2022)
Fifty-six patients (48±15 years; 64% females) were included, with dried cannabis (53%) being the most common type of cannabis consumed. Seventy percent of products were considered delta-9-tetrahydrocannabinol (Δ9-THC)-dominant. The majority of patients (96%) self-reported effective pain management, and 76% reported a significant decrease in analgesic medication usage (p≤0.001).
This study provides further support for the patient-perceived effectiveness of cannabis in managing CP symptoms and reducing analgesic medication consumption. The results suggest a potential sex difference in metabolizing cannabinoids, and the varying immune marker concentrations may support a possible immunomodulatory effect associated with patient sex and cannabis product type.
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Comparing Sublingual and Inhaled Cannabis Therapies for Low Back Pain: An Observational Open-Label Study
Dror Robinson, M.D., Ph.D., Sivan Ritter, D.V.M., B.A., and Mustafa Yassin, M.D. (October 2022)
Enrolled in the study were 24 patients whose advanced imaging studies (i.e. computerized tomography or magnetic resonance imaging of the lumbar spine) revealed disc herniation or spinal stenosis. Three patients dropped out of extract therapy treatment but resumed study participation to receive THCrich smoking therapy. After a minimum of 2 years, cannabis therapy had reduced lower back pain symptoms, as assessed by Oswestry Disability Index, the SF-12 patient-reported outcome questionnaire, and the visual analogue scale. Pain reduction was not significant during the extract treatment part of the study; however, pain reduction was significant during the inhaled therapy part of the study.
Our findings indicate that inhaled THC-rich therapy is more effective than CBD-rich sublingual extract therapy for treating low back pain and that cannabis therapy is safe and effective for chronic low back pain.
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The Use of Cannabidiol in Patients With Low Back Pain Caused by Lumbar Spinal Stenosis: An Observational Study
Brock K. Bakewell, Matthew Sherman, Kimberly Binsfeld, Asif M. Ilyas, Stephen A. Stache, Saloni Sharma, David Stolzenberg, Ari Greis (September 2022)
This observational study was investigator-initiated and designed to determine the effect of hemp-derived CBD gel caps for patients with spinal stenosis related to low back pain and leg pain relative to patient outcomes, medication utilization, and quality of life outcome measures. A total of six physician visits would be required where a set of surveys would be filled out each four weeks apart.
This open-label, prospective, observational study found that treatment with hemp-derived CBD gel caps was associated with significant improvements in pain scores and several quality-of-life measures for patients with lumbar spinal stenosis.
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The Use of Cannabidiol In Patients With Low Back Pain Caused By Lumbar Spinal Stenosis: An Observational Study
Brock K. Bakewell, Matthew Sherman, Kimberly Binsfeld, Asif M. Ilyas, Stephen A. Stache, Saloni Sharma, David Stolzenberg, Ari Greis (September 2022)
Spinal stenosis is a degenerative narrowing of the spinal canal with encroachment on the neural structures by surrounding bone and soft tissue. This chronic low back condition can cause restrictions in mobility, impairment of daily activities, opioid dependence, anxiety, depression, and reduced quality of life. Spinal stenosis can be treated through surgical and nonsurgical methods, but neither has proven consistently reliable. Cannabidiol (CBD) has also been observed to have anxiolytic, anti-inflammatory, antiemetic, and antipsychotic behaviors. CBD may provide greater nonsurgical treatment options for the pain associated with spinal stenosis while minimizing the need for opioids. An observational study was undertaken to assess the effects of CBD on patients suffering from chronic spinal stenosis.
This open-label, prospective, observational study found that treatment with hemp-derived CBD gel caps was associated with significant improvements in pain scores and several quality-of-life measures. Improvements in pain scores ultimately led to improvements in patients’ quality of life. This study did see fewer increases in quality-of-life measures than previous research involving both THC and CBD. However, the CBD gel caps were not associated with any adverse effects. Using CBD to help alleviate pain in spinal stenosis is supported by the evidence in this study. While first of its kind, this study supports the evidence that cannabis products can be a safe and effective treatment option for managing chronic pain.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Benefits And Concerns Regarding Use Of Cannabis For Therapeutic Purposes Among People Living With Chronic Pain: A Qualitative Research Study
Mahmood AminiLari, PhD, Natasha Kithulegoda, MPH, PhD Student, Patricia Strachan, PhD, James MacKillop, PhD, Li Wang, PhD, Sushmitha Pallapothu, MSc Student, Samuel Neumark, Sangita Sharma, MD, Jagmeet Sethi, MD, Ramesh Zacharias, MD, Allison Blain, MD, Lisa Patterson, Jason W Busse, DC, PhD (June 2022)
Although there is growing interest in medically authorized cannabis for chronic pain, little is known about patients’ perspectives. We explored perceptions of people living with chronic pain regarding benefits and concerns surrounding their use of cannabis for therapeutic purposes.
In this qualitative descriptive study, we conducted semi-structured interviews with 13 people living with chronic pain who used cannabis therapeutically, living in Ontario, Canada. We used thematic analysis, with data collection, coding, and analysis occurring concurrently.
People living with chronic pain reported important benefits associated with use of cannabis for therapeutic purposes, including reduced pain, improved functionality, and less risk of harms compared to prescription opioids. Most patients also acknowledged harms, such as grogginess and coughing, and there was considerable variability in patient experiences. Financial costs and stigma were identified as important barriers to use of cannabis.
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A Randomized Controlled Trial Of Topical Cannabidiol For The Treatment Of Thumb Basal Joint Arthritis
John T. Heineman MD, MPH, Grace L. Forster BS, Kristen L. Stephens MD, Patrick S. Cottler PhD, Michael P. Timko PhD, Brent R. DeGeorge Jr. MD, PhD (May 2022)
Since the passage of the Agricultural Improvement Act of 2018, hand surgeons have increasingly encountered patients seeking counseling on over-the-counter, topical cannabidiol (CBD) for the treatment of pain. To this end, we designed a human clinical trial to investigate the therapeutic potential of CBD for the treatment of pain associated with thumb basal joint arthritis.
Cannabidiol treatment resulted in improvements from baseline among patient-reported outcome measures, including Visual Analog Scale pain; Disabilities of the Arm, Shoulder, and Hand; and Single Assessment Numeric Evaluation scores, compared to the control arm during the study period. There were similar physical parameters identified with range of motion, grip, and pinch strength.
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Medical Cannabis Use Reduces Opioid Prescriptions in Patients with Osteoarthritis
Ari Greis, Bryan Renslo, Conan Liu, Anjithaa Radakrishnan, Asif M. Ilyas (January 2022)
Osteoarthritis (OA) can result in significant pain, requiring pain management with opioids. Medical cannabis (MC) has the potential to be an alternative to opioids for chronic pain conditions. This study investigates whether MC used in the management of OA-related chronic pain can reduce opioid utilization.
Forty patients with chronic OA pain were certified for MC. Average morphine milligram equivalents (MME) per day of opioid prescriptions filled within the six months prior to MC certification was compared to that of the six months after. Visual analog scale (VAS) for pain and Global Health scores were measured at baseline, three, and six months post MC certification.
Average MME/day decreased from 18.2 to 9.8 (n=40, p<0.05). The percentage of patients who dropped to 0 MME/day was 37.5%. VAS scores decreased significantly at three and six months, and Global Physical Health score increased significantly by three months.
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Medical Cannabis Use Reduces Opioid Prescriptions in Patients with Chronic Back Pain
Ari Greis, Bryan Renslo, Adrianne R. Wilson-Poe, Conan Liu, Anjithaa Radakrishnan, Asif M. Ilyas (January 2022)
The study included 186 patients with chronic back pain who were certified for MC use. The average morphine milligram equivalent (MME)/day of opioid prescriptions filled within the six months prior to MC certification was compared to that of six months after. Pain and disability questionnaires were distributed at three, six, and nine months post-certification.
Among patients with chronic musculoskeletal noncancer back pain who were certified for MC, they filled a significantly reduced amount of opioid prescriptions post-MC compared to pre-MC. Upon MC certification, patients with lower levels of baseline opioid use have a high chance of stopping opioid use altogether. Patients show improved pain scores and daily function scores following MC certification. The use of multiple routes of administration simultaneously may be more efficacious in reducing opioid utilization.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Medical Cannabis Certification Is Associated with Decreased Opiate Use in Patients with Chronic Pain: A Retrospective Cohort Study in Delaware
Balu A, Mishra D, Marcu J, et al. (December 2021)
In this study, we examined individuals who were provided with legal; medical cannabis certifications in the state of Delaware between June 2018 and October 2019 and were concurrently being treated with opioid medications for chronic pain at a private pain management practice. Using a posthoc analysis, we conducted a retrospective cohort study on the individuals (n = 81) to determine if there was a decrease in their opioid use following medical cannabis certification. Opioid use was measured in morphine milligram equivalent (MME) through the Delaware prescription monitoring program (PMP) database.
Overall, the average change in prescribed opioid use was found to be -12.3 morphine milligram equivalent (MME) units when including all individuals (p < 0.00001). Among the included individuals with baseline opioid use, medical cannabis certification was associated with a 31.3% average decrease in opioid use (n = 63). When examining subgroups based upon pain location, individuals with neck pain displayed a 41.5% average decrease in MME (n = 27), while individuals with low back pain were observed to have a 29.4% decrease in opioid use (n = 58). Similarly, individuals with knee pain (n = 14) reduced their opioid use by 32.6%.
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Medical Cannabis Used as an Alternative Treatment for Chronic Pain Demonstrates Reduction in Chronic Opioid Use — A Prospective Study
Gregory Benedict, MD, Annas Sabbagh, DO, and Till Conermann, MD (October 2021)
This single-center prospective study follows a group of patients trialing medical cannabis treatment for chronic pain that is already using COT in order to determine individual efficacy. Continued medical cannabis treatment was a decision made by the patient, after trialing medical cannabis, to either continue medical cannabis along with COT at a reduced daily MME, or to revert back to their previous COT regimen.
There was a 67.1% average decrease in daily MME/patient from 49.9 to 16.4 MME at the first follow-up. There was a 73.3% decrease in MME at second follow-up from 49.9 to 13.3 MME with an ANOVA analysis denoting a significant difference of P < 0.0001.
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Effects of Cannabis Ingestion on Endometriosis-Associated Pelvic Pain and Related Symptoms
Justin Sinclair, Laura Collett, Jason Abbott, David W. Pate, Jerome Sarris, Mike Amour (October 2021)
A retrospective, electronic record-based cohort study of StrainprintTM users with self-reported endometriosis was conducted. Self-rated cannabis efficacy, defined as a function of initial and final symptom ratings, was investigated across the included symptom clusters of cramps, pelvic pain, gastrointestinal pain, nausea, depression, and low libido. Cannabis dosage form, dose and cannabinoid ratio information was also recorded.
Cannabis appears to be effective for pelvic pain, gastrointestinal issues and mood, with effectiveness differing based on method of ingestion. The greater propensity for use of an inhaled dosage delivery may be due to the rapid onset of pain-relieving effects versus the slower onset of oral products. Oral forms appeared to be superior compared to inhaled forms in the less commonly reported mood or gastrointestinal categories. Clinical trials investigating the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms are urgently required.
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The Effect of Medical Cannabis on Pain Level and Quality of Sleep Among Rheumatology Clinic Outpatients
George Habib, Fadi Khazin, Suheil Artul (September 2021)
Medical cannabis (MC) is becoming increasingly popular for the treatment of chronic pain conditions. In this study, we evaluated the effect of MC treatment on pain level and quality of sleep of patients with different medical conditions at the rheumatology clinic.
MC has a favorable effect on pain level and sleep quality among nearly the entire spectrum of resistant “chronic pain syndromes” seen or referred to rheumatology clinics, including inflammatory diseases resistant to biological treatment, although the effect of MC on synovitis was relatively mild. Cannabis should be seriously considered in every “chronic pain condition” whenever the accepted modalities of treatment are insufficient for alleviating patient’s pain and sleep problems.
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Prolonged Medical Cannabis Treatment is Associated With Quality of Life Improvement and Reduction of Analgesic Medication Consumption in Chronic Pain Patients
Joshua Aviram, Gil M. Lewitus, Yelena Vysotski, Ben Yellin, Paula Berman, Anna Shapira, David Meiri (May 2021)
In this study, although pain intensities did not change under long-term MC treatment, analgesic medication consumption rates decreased and 'better' QoL rates increased. These changes coincided with the increased rates of patients’ consumption of high dose THC and α pinene. These results may shed light on the long-term beneficial effects of MC on CNCP. Nevertheless, due to our findings regarding high rates of MC-related AEs, close physician follow-up, even after prolonged treatment durations, is recommended.
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Cannabinoid And Opioid Use Among Total Joint Arthroplasty Patients: A 6-Year, Single-Institution Study
Sahitya K. Denduluri, Steven T. Woolson, Pier F. Indelli, Edward R. Mariano, Alex H. S. Harris, Nicholas J. Giori (October 2020)
Evidence is limited regarding cannabinoid use among total joint arthroplasty patients, despite increased availability and popularity for treating chronic pain. The authors hypothesized that preoperative cannabinoid use increased and opioid use decreased during a 6-year interval in total hip arthroplasty and total knee arthroplasty patients, and also asked whether complications were associated with use of these substances.
During a 6-year period, cannabinoid use increased more than 60%, and opioid used decreased approximately 30%. These findings indicate that cannabinoid use did not appear to be associated with perioperative complications.
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Medical Cannabis And Cognitive Performance In Middle To Old Adults Treated For Chronic Pain
Sharon R. Sznitman PhD, Senior Lecturer, Simon Vulfsons MD, Director, David Meiri PhD, Lecturer, Galit Weinstein PhD, Senior Lecturer (September 2020)
A cross-sectional study was conducted among chronic pain patients aged 50+ years who had MC licenses and a comparison group who did not have MC licenses. CogState computerised brief battery was used to assess cognitive performance of psychomotor reaction, attention, working memory and new learning. Furthermore, the associations between MC use patterns (dosage, cannabinoid concentrations, length and frequency of use and hours since last use) with cognition were assessed among MC licensed patients.
These results suggest that use whole plant MC does not have a widespread impact on cognition in older chronic pain patients.
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The Impact Of Medical Cannabis On Intermittent And Chronic Opioid Users With Back Pain: How Cannabis Diminished Prescription Opioid Usage
Kevin M. Takakuwa, Jeffrey Y. Hergenrather, Frances S. Shofer, Raquel M. Schears (September 2020)
In this long-term observational study, cannabis use worked as an alternative to prescription opioids in just over half of patients with low back pain and as an adjunct to diminish use in some chronic opioid users.
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Medical Cannabis For The Reduction Of Opioid Dosage In The Treatment Of Non-Cancer Chronic Pain: A Systematic Review
Babsola O. Okusanya, Ibitola O. Asaolu, John E. Ehiri, Linda Jepkoech Kimaru, Abidemi Okechukwu, Cecilia Rosales (July 2020)
This review assessed if MC used in combination with opioids to treat non-cancer chronic pain would reduce opioid dosage.
Nine studies involving 7222 participants were included. There was a 64-75% reduction in opioid dosages when used in combination with MC.
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Cannabis Against Chronic Musculoskeletal Pain: A Scoping Review On Users And Their Perceptions
Daniela Furrer, Edeltraut Kröger, Martine Marcotte, Nathalie Jauvin, Richard Bélanger, Mark Ware, Guillame Foldes-Busque, Michèle Aubin, Pierre Pluye, Clermont E. Dionne (July 2020)
Participants of the 49 included studies reported that MC use helped them to reduce CMP and other chronic non-cancer pain, with only minor adverse effects, and some reported improved psychological well-being.
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Medical Cannabis for the Management of Pain and Quality of Life in Chronic Pain Patients: A Prospective Observational Study
Ramin Safakish, Gordon Ko, Vahid Salimpour, Bryan Hendin, Imrat Sohanpal, Gena Loheswaran, Sun Young Rosalia Yoon (June 2020)
Taken together, the findings of this study add to the cumulative evidence in support of plant-based medical cannabis as a safe and effective treatment option and potential opioid medication substitute or augmentation therapy for the management of symptoms and quality of life in chronic pain patients.
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Cannabinoids in Chronic Non-Cancer Pain: A Systematic Review and Meta-Analysis
Herman Johal, Tahira Devji, Yaping Chang (February 2020)
For patients with chronic, non-cancer pain, traditional pain-relieving medications include opioids, which have shown benefits but are associated with increased risks of addiction and adverse effects. Medical cannabis has emerged as a treatment alternative for managing these patients and there has been a rise in the number of randomized clinical trials in recent years; therefore, a systematic review of the evidence was warranted.
There was moderate evidence to support cannabinoids in treating chronic, non-cancer pain at 2 weeks. Similar results were observed at later time points, but the confidence in effect is low. There is little evidence that cannabinoids increase the risk of experiencing serious AEs, although non-serious AEs may be common in the short-term period following use.
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Cannabis and Cannabinoids in the Treatment of Rheumatic Diseases
Tal Gonen, Howard Amital (January 2020)
Chronic pain is a common complaint among patients, and rheumatic diseases are a common cause for chronic pain. Current pharmacological interventions for chronic pain are not always useful or safe enough for long-term use. Cannabis and cannabinoids are currently being studied due to their potential as analgesics. In this review we will discuss current literature regarding cannabinoids and cannabis as treatment for rheumatic diseases.
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The Impact of Medical Cannabis on Intermittent and Chronic Opioid Users with Back Pain: How Cannabis Diminished Prescription Opioid Usage
Kevin Takakuwa, Jeffrey Hergenrather, Frances Shofer and Raquel Schears (January 2020)
There were no between-group differences based on demographic, experiential, or attitudinal variables. We found that 50.8% were able to stop all opioid usage, which took a median of 6.4 years (IQR=1.75–11 years) after excluding two patients who transitioned off opioids by utilizing opioid agonists. For those 29 patients (47.5%) who did not stop opioids, 9 (31%) were able to reduce opioid use, 3 (10%) held the same baseline, and 17 (59%) increased their usage. Forty-eight percent of patients subjectively felt like cannabis helped them mitigate their opioid intake but this sentiment did not predict who actually stopped opioid usage. There were no variables that predicted who stopped opioids, except that those who used higher doses of cannabis were more likely to stop, which suggests that some patients might be able to stop opioids by using cannabis, particularly those who are dosed at higher levels.
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Cannabis for pain in orthopedics: a systematic review focusing on study methodology
Madden, George, van der Hoek, Borim, Mammen and Bhandari (December 2019)
Medical cannabis use is an emerging topic of interest in orthopedics. Although there is a large amount of literature on medical cannabis use for managing various types of pain, few studies have focused on orthopedic conditions. There is little high-quality evidence in core orthopedic areas. The objective of this study was to summarize the literature on the efficacy of cannabis use for pain related to orthopedic conditions.
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Perceived Efficacy of Medical Cannabis in the Treatment of Co-Occurring Health-Related Quality of Life Symptoms
Douglas Bruce, Elissa Foster & Mona Shattell (November 2019)
For persons living with chronic conditions, health-related quality of life (HRQoL) symptoms, such as pain, anxiety, depression, and insomnia, often interact and mutually reinforce one another. There is evidence that medical cannabis (MC) may be efficacious in ameliorating such symptoms and improving HRQoL. As many of these HRQoL symptoms may mutually reinforce one another, we conducted an exploratory study to investigate how MC users perceive the efficacy of MC in addressing co-occurring HRQoL symptoms. We conducted a cross-sectional online survey of persons with a state medical marijuana card in Illinois (N = 367) recruited from licensed MC dispensaries across the state. We conducted tests of ANOVA to measure how perceived MC efficacy for each HRQoL symptom varied by total number of treated symptoms reported by participants. Pain was the most frequently reported HRQoL treated by MC, followed by anxiety, insomnia, and depression. A large majority of our sample (75%) reported treating two or more HRQoL symptoms. In general, perceived efficacy of MC in relieving each HRQoL symptom category increased with the number of co-occurring symptoms also treated with MC. Perceived efficacy of MC in relieving pain, anxiety, and depression varied significantly by number of total symptoms experienced. This exploratory study contributes to our understanding of how persons living with chronic conditions perceive the efficacy of MC in treating co-occurring HRQoL symptoms. Our results suggest that co-occurring pain, anxiety, and depression may be particularly amenable to treatment with MC.
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Role of Cannabinoids and Terpenes in Cannabis-Mediated Analgesia in Rats
Hannah Harris, Margaret Rousseau, Amira Wanas, Mohamed Radwan, Sylvia Caldwell, Kenneth Sufka, and Mahmoud ElSohly (October 2019)
In the thermal assays, hotplate and tail-flick latencies for morphine-treated rats were dose dependent and significantly higher than vehicle-treated animals. All the cannabinoid compounds except for the isolated terpenes produced dose-dependent increases in hotplate and tail-flick latencies. In the inflammatory nociceptive assay, animals treated with vehicle and isolated terpenes demonstrated increased abdominal writhing, whereas all the cannabinoid compounds significantly decreased abdominal writhing responses.
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Perception of Benefits and Harms of Medical Cannabis among Seriously Ill Patients in an Outpatient Palliative Care Practice
Ali John Zarrabi, Justine W. Welsh, Roman Sniecinski, Kimberly Curseen, Theresa Gillespie, Wendy Baer, Anne Marie McKenzie-Brown and Vinita Singh (September 2019)
All 101 patients invited to participate completed the survey. A majority had cancer (76%) and were married (61%), disabled or retired (75%), older than 50 years of age (64%), and men (56%). Most patients ingested (61%) or vaporized (49%) cannabis products. A majority of respondents perceived cannabis to be important for their pain (96%) management. They reported that side effects were minimally bothersome, and drowsiness was the most commonly reported bothersome harm (28%). A minority of patients reported cannabis withdrawal symptoms (19%) and concerns for dependency (14%). The majority of patients were using concurrent prescription opioids (65%). Furthermore, a majority of cancer patients reported cannabis as being important for cancer cure (59%).
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Cannabinoids and Pain Management: an Insight into Recent Advancements
Amna Shaikh and Sarah Money (September 2019)
Patients with neuropathic pain, cancer pain, and migraine headache may benefit from the analgesic effects of a cannabis-based medicine (CBM), but not necessarily patients with chronic abdominal pain. Equivocal results were shown in fibromyalgia and postoperative orthopedic pain. Interestingly, the opioid-sparing properties of CBM make it an attractive option for pain management. However, the scale and quality of studies conducted are limited. Further research is necessary to establish recommendation guidelines for medical cannabis in pain management.
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The effects of cannabis, cannabinoids, and their administration routes on pain control efficacy and safety: A systematic review and network meta-analysis
Karma Rabgay, Neti Waranuch, Nathorn Chaiyakunapruk, Ratree Sawangjit, Kornkanok Ingkaninan and Piyameth Dilokthornsakul (September 2019)
The use of cannabis and cannabinoids via certain administration routes could reduce different types of pain. Product developers could consider our findings as part of their product design so that the effective route of cannabis and cannabinoids for pain control can be achieved.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Dronabinol in geriatric pain and palliative care patients
Christoph Wendelmuth, Stefan Wirz, Misel Torontali, Anne Gastmeier and Knud Gastmeier Schwerpunkt (September 2019)
Geriatric patients often suffer from a long history of pain and have a limited life expectancy. Cannabinoid receptor agonists like dronabinol may be an effective, low-risk treatment option for geriatric patients with chronic pain. The effectiveness and side effects of dronabinol therapy in geriatric patients are analyzed. The effects of the approval requirement are presented. This study is one of the few analyses of the use of Dronabinol in geriatric patients. We show that cannabis-based drugs (in this case dronabinol) are an effective, low-risk treatment option that should be considered early in therapy. Regarding the indication spectrum, further clinical studies and an approval-free test phase are necessary.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
The Effectiveness of Self-Directed Medical Cannabis Treatment for Pain
Xiaoxue Li, Jacob M. Vigil, Sarah S.Stith, Franco Brockelman, Keenan Keeling and Branden Hall (August 2019)
The prior medical literature offers little guidance as to how pain relief and side effect manifestation may vary across commonly used and commercially available cannabis product types. We used the largest dataset in the United States of real-time responses to and side effect reporting from patient-directed cannabis consumption sessions for the treatment of pain under naturalistic conditions in order to identify how cannabis affects momentary pain intensity levels and which product characteristics are the best predictors of therapeutic pain relief. Between 06/06/2016 and 10/24/2018, 2,987 people used the ReleafApp to record 20,513 cannabis administration measuring cannabis’ effects on momentary pain intensity levels across five pain categories: musculoskeletal, gastrointestinal, nerve, headache-related, or non-specified pain. The average pain reduction was –3.10 points on a 0-10 visual analogue scale (SD = 2.16, d = 1.55, p < .001).
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Cannabis-based medicines for chronic pain management
Haggaia Sharon and Silviu Brill (August 2019)
Purpose of review The medicinal use of cannabis has recently become the focus of much medical, as well as political, attention. This reality of growing use but limited evidence creates unique dilemmas for the prescribing clinician. The purpose of this review is to explore current evidence and gaps in knowledge and offer some practical considerations. Recent findings There is robust preclinical data regarding the relevance of the endocannabinoid system to many pain-relevant processes. However, evidence to support cannabis-based medicines clinical use is still lacking. The best evidence to date is in managing neuropathic pain, although whether effects are clinically significant remains undetermined. However, the safety profile of cannabinoids seems favorable, especially by comparison to other medications used for pain control.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Efficacy and safety of medicinal cannabis: results of the CaPRis study
Eva Hoch, Chris Friemel, Miriam Schneider, Oliver Pogarell, Alkomiet Hasan, Ulrich W. Preuss and CaPRis-Projektgruppe (June 2019)
The project “Cannabis: Potential and Risks: a Scientific Analysis” (CaPRis), which started in 2016, aimed at analyzing the potential of medicinal cannabis and the risks of recreational cannabis use. A search of systematic reviews (SRs) and randomized-controlled trials (RCTs) were conducted in five international databases (publication date: 2006–2017). For the medical use of cannabis 16 SRs (of 186 RCTs) were included from a global search and nine further RCTs were comprised from a de novo search. All studies were methodologically assessed. Evidence for the efficacy of cannabis medicine (given as an adjunct to other medication) was found in patients with chronic pain and spasticity due to multiple sclerosis. Benefits were also found for appetite stimulation, improvement of nausea, and weight gain in patients with cancer, HIV/AIDS or in palliative care.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Effectiveness and tolerability of THC:CBD oromucosal spray as add-on measure in patients with severe chronic pain: analysis of 12-week open-label real-world data provided by the German Pain e-Registry
Michael Ueberall, Ute Essner and Gerhard Mueller-Schwefe (June 2019)
Objective: To evaluate effectiveness, tolerability and safety of an oromucosal spray containing Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), as add-on treatment in patients with severe chronic pain (SCP). Conclusion: THC:CBD oromucosal spray proved to be an effective and well-tolerated add-on treatment for patients with elsewhere refractory chronic pain – especially of neuropathic origin.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Patterns of Marijuana Use and Health Impact: A Survey Among Older Coloradans
Hillary D. Lum, Kanika Arora, J. Alton Croker, Sara H. Qualls, Melissa Schuchman, Julie Bobitt, Gary Milavetz, and Brian Kaskie (June 2019)
The in-person or online survey was offered to community-dwelling older persons aged above 60 years. We assessed past-year marijuana use including recreational, medical, or both; methods of use; marijuana source; reasons for use; sociodemographic and health factors; and self-reported health. Of 274 respondents (mean age = 72.5 years, 65% women), 45% reported past-year marijuana use. Of these, 54% reported using marijuana both medically and recreationally. Using more than one marijuana method or preparation was common. Reasons for use included arthritis, chronic back pain, anxiety, and depression. Past-year marijuana users reported improved overall health, quality of life, day-to-day functioning, and improvement in pain. Odds of past-year marijuana use decreased with each additional year of age.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Medical Cannabis: Effects on Opioid and Benzodiazepine Requirements for Pain Control
Megan O’Connell, Megan Sandgren, Leah Frantzen, Erika Bower and Brian Erickson (May 2019)
There is currently little evidence regarding the use of medical cannabis for the treatment of intractable pain. Literature published on the subject to date has yielded mixed results concerning the efficacy of medical cannabis and has been limited by study design and regulatory issues. The objective of this study was to determine if the use of medical cannabis affects the amount of opioids and benzodiazepines used by patients on a daily basis.
Important Notice
If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Effects of cannabinoid administration for pain: A meta-analysis and meta-regression
Julio Yanes, Zach McKinnell, Meredith Reid, Jessica Busler, Michel, Jesse Michel, Melissa Pangelinan, Matthew Sutherland, Jarred Younger, Gonzalez, Raul Gonzalez and Jennifer Robinson (May 2019)
Chronic pain states have resulted in an overreliance on opioid pain relievers, which can carry significant risks when used long term. As such, alternative pain treatments are increasingly desired. Although emerging research suggests that cannabinoids have therapeutic potential regarding pain, results from studies across pain populations have been inconsistent. To provide meta-analytic clarification regarding cannabis’s impact on subjective pain, we identified studies that assessed drug-induced pain modulations under cannabinoid and corresponding placebo conditions. A literature search yielded 25 peer-reviewed records that underwent data extraction.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Pain Relief as a Motivation for Cannabis Use Among Young Adult Users With and Without Chronic Pain
Fales, Jessica L; Ladd, Benjamin O; Magnan, Renee E (February 2019)
Results revealed that approximately 40% of the sample met the criteria for chronic pain, and pain relief was their primary motivation for use. There were no differences between groups with respect to frequency of use or estimated potency of their preferred strains; however, users with chronic pain reported using a wider variety of administration methods and a greater quantity of cannabis with each use. Users with chronic pain also reported more extensive histories of use, with younger age at initiation and longer duration of regular use. Despite riskier consumption patterns, there were no between-group differences in negative consequences owing to use after controlling for gender and educational status.
Important Notice
If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Association of Cannabinoid Administration With Experimental Pain in Healthy Adults
Martin J. De Vita, MS; Dezarie Moskal, MS; Stephen A. Maisto, PhD; et al (September 2018)
What is the association between acute cannabinoid administration and experimental pain reactivity in healthy adults? This systematic review and meta-analysis of 18 studies including 442 adults found that cannabinoid drugs were associated with modest increases in experimental pain threshold and tolerance, no reduction in the intensity of ongoing experimental pain, reduced perceived unpleasantness of painful stimuli, and no reduction of mechanical hyperalgesia. Cannabinoid analgesia may be largely driven by an affective rather than a sensory component. These findings have implications for understanding the analgesic properties of cannabinoids.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain
Mondello E, Quattrone D, Cardia L, Bova G, Mallamace R, Barbagallo AA, Mondello C, Mannucci C, Di Pietro M, Arcoraci V, Calapai G (September 2018)
This study aimed to evaluate pain and its symptoms in patients with failed back surgery syndrome (FBSS) refractory to other therapies, treated with a combination of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), in association with spinal cord stimulation (SCS). The results indicate that cannabinoid agonists (THC/CBD) can have remarkable analgesic capabilities, as adjuvant of SCS, for the treatment of chronic refractory pain of FBSS patients.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science
Eric P. Baron (August 2018)
There is accumulating evidence for various therapeutic benefits of cannabis/cannabinoids, especially in the treatment of pain, which may also apply to the treatment of migraine and headache. There is also supporting evidence that cannabis may assist in opioid detoxification and weaning, thus making it a potential weapon in battling the opioid epidemic. Cannabis science is a rapidly evolving medical sector and industry with increasingly regulated production standards. Further research is anticipated to optimize breeding of strain‐specific synergistic ratios of cannabinoids, terpenes, and other phytochemicals for predictable user effects, characteristics, and improved symptom and disease‐targeted therapies.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort
Eric P. Baron, Philippe Lucas, Joshua Eades and Olivia Hogue (May 2018)
Medicinal cannabis registries typically report pain as the most common reason for use. It would be clinically useful to identify patterns of cannabis treatment in migraine and headache, as compared to arthritis and chronic pain, and to analyze preferred cannabis strains, biochemical profiles, and prescription medication substitutions with cannabis.
Important Notice
If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Efficacy, tolerability and safety of cannabis-based medicines for cancer pain
Winfried Häuser, Patrick Welsch, Petra Klose, Lukas Radbruch and Mary-Ann Fitzcharles (May 2019)
A systematic literature search until December 2018 included CENTRAL, PubMed, SCOPUS and trial registers. Randomised controlled trials (RCTs) investigating medical cannabis and/or pharmaceutical cannabinoids for pain control in cancer patients with a study duration of at least 2 weeks and a sample size of at least 20 participants per study arm were included. Clinical outcomes comprised efficacy (pain intensity, patient impression of improvement, combined responder, sleep problems, psychological distress, opioid maintenance and breakthrough dosage), tolerability (dropout rate due to adverse events) and safety (nervous system, psychiatric and gastrointestinal side effects; serious adverse events). The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Cannabis for Treatment of Chronic Pelvic Pain: A Survey of Prevalence and Effectiveness
Charity Johns and Mark Lachiewicz (May 2019)
Chronic pelvic pain (CPP) is a prevalent but difficult entity to treat. Cannabis has been shown to significantly improve pain in several populations. There have been no studies on cannabis use among women with CPP. We aim to examine the prevalence of cannabis use in patients with CPP and hypothesize that CPP patients report an improvement in their pain symptoms with cannabis use.
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If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.
Outcomes Mandate National Integration With Cannabis as Medicine
Ryan O Lakin (OMNI Medical Services, LLC) (May 2019)
This study will utilize an anonymous novel online questionnaire to determine study participants' qualifying condition(s) for medical cannabis use, cannabis ingestion method, frequency of use, prescription drug use, and demographic information. Secondary factors will include evaluation of pain control, quality of life metrics, any adverse side effects from cannabis use, as well as changes in adjunctive treatments. Patients will be given medical cannabis recommendations and certifications commensurate with the state law in which the encounter occurs. The variations in mechanisms between the states for recommending, registering, certifying, and developing mandated treatment plans or doses will be adhered to; however, variations in state law and cannabis programs should not cause variation in the study design because the end-result is still the same with patients being treated with medical cannabis.
Important Notice
If you proceed to article you will be leaving the CB1 Capital Management website to access a website hosted by a party unrelated to CB1 Capital Management. CB1 Capital Management assumes no responsibility for the accuracy of any of these studies nor does CB1 assume any obligation to update any of these studies based on subsequent research.