Smoked cannabis for chronic neuropathic pain: a randomized controlled trial

Title

Smoked cannabis for chronic neuropathic pain: a randomized controlled trial

Creator

Ware M; Wang T; Shapiro S; Robinson A; Ducruet T; Huynh T; Gamsa A; Bennett GJ; Collet JP

Identifier

Publisher

Canadian Medical Association Journal

Date

2010

Subject

Female; Humans; Male; Pain Measurement; Adult; Aged; Middle Aged; Treatment Outcome; Linear Models; Double-Blind Method; Cross-Over Studies; quality of life; Chronic disease; Sleep/drug effects; Placebos; Neuralgia/drug therapy; Marijuana Smoking; Tetrahydrocannabinol/administration & dosage/adverse effects/therapeutic use

Description

BACKGROUND: Chronic neuropathic pain affects 1%-2% of the adult population and is often refractory to standard pharmacologic treatment. Patients with chronic pain have reported using smoked cannabis to relieve pain, improve sleep and improve mood. METHODS: Adults with post-traumatic or postsurgical neuropathic pain were randomly assigned to receive cannabis at four potencies (0%, 2.5%, 6% and 9.4% tetrahydrocannabinol) over four 14-day periods in a crossover trial. Participants inhaled a single 25-mg dose through a pipe three times daily for the first five days in each cycle, followed by a nine-day washout period. Daily average pain intensity was measured using an 11-point numeric rating scale. We recorded effects on mood, sleep and quality of life, as well as adverse events. RESULTS: We recruited 23 participants (mean age 45.4 [standard deviation 12.3] years, 12 women [52%]), of whom 21 completed the trial. The average daily pain intensity, measured on the 11-point numeric rating scale, was lower on the prespecified primary contrast of 9.4% v. 0% tetrahydrocannabinol (5.4 v. 6.1, respectively; difference = 0.7, 95% confidence interval [CI] 0.02-1.4). Preparations with intermediate potency yielded intermediate but nonsignificant degrees of relief. Participants receiving 9.4% tetrahydrocannabinol reported improved ability to fall asleep (easier, p = 0.001; faster, p < 0.001; more drowsy, p = 0.003) and improved quality of sleep (less wakefulness, p = 0.01) relative to 0% tetrahydrocannabinol. We found no differences in mood or quality of life. The most common drug-related adverse events during the period when participants received 9.4% tetrahydrocannabinol were headache, dry eyes, burning sensation in areas of neuropathic pain, dizziness, numbness and cough. CONCLUSION: A single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis three times daily for five days reduced the intensity of pain, improved sleep and was well tolerated. Further long-term safety and efficacy studies are indicated. (International Standard Randomised Controlled Trial Register no. ISRCTN68314063).
2010

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

E694-701

Issue

14

Volume

182

Citation

Ware M; Wang T; Shapiro S; Robinson A; Ducruet T; Huynh T; Gamsa A; Bennett GJ; Collet JP, “Smoked cannabis for chronic neuropathic pain: a randomized controlled trial,” Pediatric Palliative Care Library, accessed January 19, 2022, https://pedpalascnetlibrary.omeka.net/items/show/13999.

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