Could marijuana be an effective pain alternative to prescription medications?

July 1, 2019

Science Daily/Taylor & Francis Group

A new study has shown how cannabis could be an effective treatment option for both pain relief and insomnia, for those looking to avoid prescription and over the counter pain and sleep medications -- including opioids.

The study, published in the Journal of Psychoactive Drugs, which looked at 1,000 people taking legalized marijuana in an American state found that among the 65% of people taking cannabis for pain, 80% found it was very or extremely helpful.

This led to 82% of these people being able to reduce, or stop taking over the counter pain medications, and 88% being able to stop taking opioid painkillers.

74% of the 1,000 interviewees bought it to help them sleep -- 84% of whom said the marijuana had helped them, and over 83% said that they had since reduced or stopped taking over-the-counter or prescription sleep aids.

The study suggests that cannabis could lower opioid use. However, the researchers caution that more needs to be done to understand the potential therapeutic benefits of cannabis.

"Approximately 20% of American adults suffer from chronic pain, and one in three adults do not get enough sleep," says Dr Gwen Wurm, Assistant Professor of Clinical Pediatrics at the University of Miami Miller School of Medicine.

Traditional over the counter medications and painkillers can help, however they may have serious side effects. Opioids depress the respiratory system, meaning that overdoses may be fatal.

"People develop tolerance to opioids, which means that they require higher doses to achieve the same effect," says Dr. Julia Arnsten, Professor of Medicine at Albert Einstein College of Medicine. "This means that chronic pain patients often increase their dose of opioid medications over time, which in turn increases their risk of overdose."

Although less common, sleeping pills can lead to dependence, and can also cause grogginess the next day, interfering with people's work and social lives.

As a consequence, some people are looking to marijuana to help with their symptoms.

To find out more about these users, Wurm and her colleagues used survey data from people who purchased cannabis from two retail stores in Colorado, US, where it is legal for both medical and recreational use -- meaning any adult over 21 with a valid government ID may purchase product.

"In states where adult use of cannabis is legal, our research suggests that many individuals bypass the medical cannabis route (which requires registering with the state) and are instead opting for the privacy of a legal adult use dispensary," says Wurm.

Although the survey was conducted among customers willing to participate -- meaning the results may not reflect the overall population of dispensary customers -- other national survey data, and data from medical patients at medical cannabis dispensaries, also demonstrate that people who use cannabis to treat symptoms both decrease and stop their use of prescription medications.

The study adds weight to the theory that widening access to medical cannabis could lower the use of prescription painkillers, allowing more people to manage and treat their pain without relying on opioid prescription drugs that have dangerous side effects.

This is backed up with other research that shows that states with medical cannabis laws have a 6.38% lower rate of opioid prescribing, and that Colorado's adult-use cannabis law is associated with a relative reduction in opioid overdose death rate from 1999 to 2010.

Wurm adds: "Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen cause GI bleeding or kidney damage with chronic use. Paracetemol (Acetaminophen) toxicity is the second most common cause of liver transplantation worldwide, and is responsible for 56,000 ER visits, 2600 hospitalizations, and 500 deaths per year in the U.S."

However, the researchers caution that more research is needed to understand the health benefits and side effects of cannabis.

"The challenge is that health providers are far behind in knowing which cannabis products work and which do not. Until there is more research into which cannabis products work for which symptoms, patients will do their own "trial and error," experiments, getting advice from friends, social media and dispensary employees," says Wurm.

https://www.sciencedaily.com/releases/2019/07/190701224523.htm

Nerve pain in the legs? Medical marijuana may alter brain connections, bring relief

September 5, 2018

Science Daily/American Academy of Neurology

When medical marijuana is taken for chronic nerve pain, it may provide pain relief by reducing connections between the areas of the brain that process emotions and sensory signals, according to a study published in the September 5, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study looked specifically at radicular pain, a type of nerve pain that radiates from the spine into the legs. Sciatica is a common form of radicular pain.

The component of marijuana examined in this study was tetrahydrocannabinol (THC), one of many cannabinoids found in marijuana and the one most commonly associated with producing a high.

"Pain is a complex experience that involves both the senses and emotions," said study author Haggai Sharon, MD, of the Sagol Brain Institute, Tel Aviv Medical Center in Israel. "Our study results link pain relief from THC with a reduction in the connections between areas of the brain otherwise heavily connected, suggesting that THC may alleviate pain by disrupting signals between these pain processing pathways."

The study involved 15 men with chronic radicular nerve pain with an average age of 33. Women were excluded since hormone fluctuations during menstruation may affect pain sensitivity. All participants had medium to high radicular pain for over six months.

Before treatment, participants rated their pain levels and had brain scans with functional magnetic resonance imaging (fMRI) to look at the connections between various areas of the brain. Participants were then given treatment with THC.

For the first visit, nine participants were given an average of 15 milligrams of THC oil placed under the tongue and six were given placebo oil. One hour after treatment, participants were questioned again, and had another brain scan approximately two hours after treatment.

At least one week later, participants returned for a second visit and those who had the placebo now received the treatment, and vice versa.

Researchers found that THC reduces a person's pain when compared to placebo. On a scale of zero to 100, before taking medication, on average participants rated their pain levels at 53. After taking THC oil, they rated their pain levels at an average of 35 compared to an average of 43 for those who were given the placebo.

In addition, the more pain relief a person experienced, the greater the reduction of connections between the areas of the brain involved in processing pain.

"Interestingly, our results also show that the more connected the areas of the brain that process emotion and sensory prior to treatment, the greater the pain relief experienced when taking THC," said Sharon. "Larger studies are needed to confirm our findings."

Limitations of the study are that women were excluded and the number of participants was small. Also, this study looked only at THC. Future studies are needed to examine how other components of the marijuana plant, like cannabidiol, may be useful in relieving pain in combination with THC.

The study was funded by the Yahel Foundation and the Israeli Ministry of Science, Technology and Space.

https://www.sciencedaily.com/releases/2018/09/180905161942.htm