Study Finds Medical Marijuana Safe And Effective For Chronic Pain Relief

Study Finds Medical Marijuana Safe And Effective For Chronic Pain Relief

In a national multicenter study investigating the safety of medical cannabis use by patients suffering from chronic pain, a research team led by Dr. Mark Ware from the McGill University Health Centre (MUHC) in Montreal, Canada has found that chronic pain patients who used cannabis daily for one year, when carefully monitored, had no increase in serious adverse events compared to pain patients who did not use cannabis. The study results, which have been published online in The Journal of Pain, will serve as a benchmark study on cannabis side effects of when used for pain management.

The Journal of Pain Open Access paper, entitled Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS) (The Journal of Pain, 2015; DOI: http://dx.doi.org/10.1016/j.jpain.2015.07.014), is coauthored by Mark A. Ware, MBBS MRCP MS, Tongtong Wang, BMed PhD, Stan Shapiro, PhD, Jean-Paul Collet, MD PhD, Aline Boulanger, MD, John M. Esdaile, MD, Allan Gordon, MD, Mary Lynch, MD, Dwight E. Moulin, MD, and Colleen OConnell, MD.

The coauthors note that Cannabis is widely used as a self-management strategy by patients with a wide range of symptoms and diseases including chronic noncancer pain, but the safety of cannabis use for medical purposes has not been systematically evaluated.

They conducted a prospective cohort study to describe safety issues among subjects with chronic noncancer pain, with a standardized herbal cannabis product containing a consistent 12.5% Tetrahydrocannabinol (THC) was dispensed to eligible subjects for a one-year period. Controls were subjects with chronic pain from the same clinics who were not cannabis users. The study’s primary outcome consisted of serious adverse events (SAEs) and non-serious adverse events (AEs). Secondary safety outcomes included pulmonary and neurocognitive function and standard hematology, biochemistry, renal, liver and endocrine function. Secondary efficacy parameters included pain and other symptoms, mood, and quality of life.

Beginning in 2004, 215 individuals with chronic pain were recruited to the cannabis group (141 current users and 58 ex-users) and 216 controls (persons with chronic pain but no current cannabis users) from seven clinics across Canada, located in Fredericton, New Brunswick; Halifax, Nova Scotia; London and Toronto,Ontario; Vancouver, British Columbia; and Montreal, Quebec (two sites). The median daily cannabis dose was 2.5g herbal cannabis per day from a licensed cannabis producer and dispensed through the hospital pharmacy at each site. Patient participants collected their supply every month after completing the necessary visits and tests, with medication delivered via smoking, vaporization, or as edibles. There was no difference in risk of SAEs between groups. Medical cannabis users were at increased risk of non-serious AEs (adjusted most of which were mild to moderate such as headache, nausea, dizziness, somnolence, and respiratory problems associated with smoking), and there were no differences in secondary safety assessments.

Based on the study findings, the researchers conclude that 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, and that longer term monitoring for functional outcomes is needed The study was registered with http://www.controlled-trials.com (ISRCTN19449752).

wareM“This is the first and largest study of the long term safety of medical cannabis use by patients suffering from chronic pain ever conducted,” says lead author, Dr. Ware, pain specialist at the Montreal General Hospital of the MUHC and associate professor in Family Medicine and Anesthesia at McGill University, in a McGill release “We found that medical cannabis, when used by patients who are experienced users, and as part of a monitored treatment program for chronic pain over one year, appears to have a reasonable safety profile.”

Along with information on adverse effects, subjects underwent lung function and cognitive testing, and were asked about their pain, mood and quality of life over the one year of follow up. Several of the subjects underwent complete panels of blood tests for routine biochemistry, liver and kidney function, and selected hormone levels.

“Our data show that daily cannabis users had no greater risk than non-users (control group) to experience serious adverse events,” says Dr. Ware, who is also a researcher for the Brain Repair and Integrative Neuroscience Program at the RI-MUHC. ”We found no evidence of harmful effects on cognitive function, or blood tests among cannabis consumers and we observed a significant improvement in their levels of pain, symptom distress, mood and quality of life compared to controls. ”

However, the researchers did report an increased risk of non-serious adverse events in medical cannabis consumers such as headache, nausea, dizziness, somnolence, and respiratory problems associated with smoking.

“It is important to note the limitations of the study,” adds Dr. Ware. “Patients were self-selected, not randomized, and most were experienced users. So what we are seeing is that it appears to be a relatively safe drug when used by people who have already determined that it helps them. We cannot draw conclusions about safety issues of new cannabis users.”

A previous study led by Dr.Ware published in 2010 in the journal CMAJ (Canadian Medical Association Journal), found that patients with chronic pain have reported using smoked cannabis to relieve pain, improve sleep and improve mood.

The study, entitled “Smoked cannabis for chronic neuropathic pain: a randomized controlled trial” (CMAJ October 5, 2010 vol. 182 no. 14 First published August 30, 2010, doi: 10.1503/cmaj.091414) is coauthored by Dr.Ware with Tongtong Wang, PhD, Stan Shapiro, PhD, Ann Robinson, RN, Thierry Ducruet, MSc, Thao Huynh, MD, Ann Gamsa, PhD, Gary J. Bennett, PhD, Jean-Paul Collet, MD PhD, variously of McGill University, Boreal Primum of Montral, Quebec.; and the University of British Columbia Centre for Applied Health Research and Evaluation in Vancouver, British Columbia.

The coauthors note that chronic neuropathic pain affects 1% to 2% of the adult population and is often resistant to standard pharmacologic treatment. Many patients with chronic pain have anecdotally reported better results using cannabis to relieve pain, improve sleep and improve mood.

Participants in the crossover trial (International Standard Randomised Controlled Trial Register no. ISRCTN68314063)
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, and 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. The investigators recorded effects on mood, sleep and quality of life, as well as adverse events.

Twenty-three participants were recruited 23 (mean age 45.4), 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 (THC) (5.4 v. 6.1, respectively Preparations with intermediate THC potency yielded intermediate but nonsignificant degrees of relief. Participants receiving 9.4% tetrahydrocannabinol reported improved ability to fall asleep faster, more drowsiness, and improved quality of sleep relative to controls receiving 0% tetrahydrocannabinol. THe investigators found no differences in mood or quality of life, and 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.

The researchers conclude that 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.

Sources:
McGill University Health Centre. Note
The Journal of Pain
CMAJ

Image Credit:
McGill University

38 comments

  1. Terri says:

    I’m definitely finding that food sensitivities, insuficiency of DAO enzyme and weather changes are driving my neuropathic migraine Fibromyalgia pain, fatigue and stiffness. Also have great diff falling asleep and I wake way too early. I use a Leaky Gut Repair powder fourth day to keep my gut sealed.

  2. Sandra says:

    This is false I used both medication and god forbid if I combine them it will cause a double whammy of sideffect.

    • Kay M says:

      Your inability to tolerate it doesn’t make a whole trial false. 2 people dropped out of this trial, the other 200+ continued. I doubt these patients, doctors, staff, etc are all making this up or lying in some other way. A 1 person study (you) isn’t comparable as 1 person doesn’t make up a study. Sad that you didn’t know that.

  3. Biscuit says:

    Where do i sign up? I’ve been a cannabis activist for 24 years and have smoked it for 33 years. Nothing, and i mean NOTHING, helps my pain more.

      • Beverly says:

        I myself live in NC as well I use the cbd oil and all though it didn’t get rid of my pain it sure does help me relax to sleep NC needs to get on board and realize something natural,is better for you than all these pain pills I would sign up for this trial in a heartbeat please let me know if I can I’d be right on it ! I suffer from so many illnesses

    • Christy says:

      Me too! I live in Indiana and I can assure you, we’ll probably be THE LAST state in the union to legalize it…even for medical use. We do however seem to be in the process of legalizing the CBD oil for epilepsy, which is a really good thing. Oh well, gotta start somewhere, right? In addition to fibro, migraines, and some chemo-related neuropathy I also have Rheumatoid Arthritis. I’ve read alot about the beneficial effects of MMJ on inflammation, especially in RA…I’m hoping something will change here in “backwardville”.

  4. Karen says:

    I am in Louisiana. I will be more than willing to participate. Send info when another test begins. I refuse to be a victim of greed with pharmas!

  5. Fran Selle says:

    I suffer from fibromylagia the pain is indescribable some days it feels like my body shuts down but the daily pain is unreal. I would love to try this

    • Tim Bossie says:

      The pain from Fibromyalgia is tremendous and many people who do not have it, or do not know someone with it, can never imagine. We hope that you find some relief.

  6. heather j. lavalley says:

    I have fibromyalgia ,chronic pain all the time as well as a brain disorder called Arnold chiari malformation of the brain there is no cure however, I have used medical marijuana it does help minimize my pain I always have migraines it helps my head not hurt I have a rare kidney disored to over all it helps take most all my pain away

    • Vicki Ohio says:

      How AWESOME For you Dear.. I Wish You Well & am Glad You can find some relief from your Terrible Pain from ALL OF YOUR AFFLICTIONS & Hope that this Continues to a Work for You.. I Only have Fibro & Horrible dehibilitating Migraines that Steal Several days a week of my Life because NOTHING WORKS for the PAIN & I LIVE in my BED For ALL THOSE DAYS WITH THE MIGRAINES UNTIL THEY ARE GONE… I CANNOT FUNCTION.. I Go to a Pain Management & a Neurologist but NONE of the INJECTIONS WORK & I Take A Load of Narcotics for MANY YEARS & I HATE ALL THESE PILLS For my Bad Joints with it all too & other stuff that’s painful.. WISH WE HAD MARIJUANA IN USE BUT THEY SAY IT WILL BE A FEW YEARS YET.. I CAN’T WAIT!!! I DO HAVE HOPE THO BECAUSE READING YOUR LETTER GAVE ME HOPE!! THANK YOU SO MUCH!!!

      • Linda Ingersoll says:

        If you cannot get medical marajauana find someone who can get you some !! I was getting through friends and now I get medical !! Keep trying because the Meds will kill you faster or make more symptoms to deal with ! I’ve been living with Fibro DDD and Extremely High Blood Pressure for years also I have had different treatments none of which worked just made it worse !!! I’m exhausted with this fight which never goes away !! But I cannot stress enough get off meds and vape or smoke you will find better relief !!!! Stay Strong

        • Maureen says:

          Right there with you both!! Do what you have to do I say.. it’s our life and we deserve it more than these kids getting it for anxiety.. medical or not, the choice is too clear.. cannabis means quality of life, pills means slow and painful messed up death. Trust me. Get big pharma out of your sacred body and start healing yourself.. all we have. Most md professional types don’t even believe we are in real suffering pain. I’m done being their guinea pig slave. I am free and powerful now.

  7. I have diabetic, non-diabetic neuropothy. I have been in constant pain for years and all I’m able to do is receive pain pills from my doctors and other pills that do nothing to help the pain. I don’t know where else to turn to help with the pain in my feet, ankles, and hands. When the pain gets severe in those places, then it starts to react to my whole body. Some one help!

    • Cathleen shriner says:

      Would like to be part of a trial. I suffer from fibromyalgia and no medicine to date helps. I m 68 and would like to experience a little pain relief

    • Sue Dahlsten says:

      Lyrica does help the neuropathy with fewer side affects than some of the other similar drugs but I’m afraid it may be causing my asthma to act up. I mail ordered the CBD oil and it hasn’t arrived yet. I’m hoping it will help so I don’t have to take the other drugs.

  8. Kim Webb says:

    I live in CO, can I buy these or will there be another trial I can participate in. My fibro pain is out of control. I also have so many migraines. Would love to find some relief!! Kim

    • Fran Selle says:

      I suffer from fibromylagia the pain is unreal at times i feel like my body is shutting down some day’s i can’t hardly walk or use my hands other day’s the back of my neck hurts so bad it feels like my head is going to fall off! Please help

  9. Princess in Pain says:

    Medical Marijuana just passed in AR but who knows just when we can get it. I suffer from fibro,spine issues, migraines, to the point my skin and hair hurt. But I’m sure you all know my Pain. I go to a pain clinic, get the too many strong meds. What else can I do when they do a urine test each month? THC works with very little pain med added. Caught between a rock and a hard place. Is it the DRS or the government? I’m not sure but take the evil pain monster away by letting us have our natural medicine. Thanks for listening.

    • Tim Bossie says:

      We are truly sorry for the pain that you struggle with each day. For many, like you, there is no solution right now to help find relief. In writing up this post we were all hopeful that this will be marketed – with approval – so that others may be able to benefit quickly.

  10. Phillip meakin says:

    Yes I would try anything that could relieve my pain ,I have fibromyalgia and diabetes it’s only by the grace of God that I make it through each day.

  11. I would love to know more about these patches as I’ve been suffering for over 16 yrs. with Fibromyalgia that started with the Epstein Barr virus, and has lead to multiple disorders such as Cronic Fatigue, Migraines, Sleep Apnea,
    Narcolepsy, IBS, Candida and recently have been diagnosed with many Virus’s and multiple Auto-Immune
    Disorders. I’m in constant pain and my ears ring and feel plugged up. Due to all these conditions, I have severe Bone Loss in my mouth, implants will not take, due to Bone Grafting that has never worked, and I have losses almost all my teeth and there’s not enough bone to support a good fit of a denture ( have to glue them in, to try to keep my self esteem. My mouth is in constant pain and causes lots of anxiety and Dental Specialist say I need complete Bone and Jaw replacement.

  12. Karen says:

    I was finally diagnosed about 15 years ago. I’ve tried all the different “Fibro” medicines that have come on the market, after a couple of months, I decide they really aren’t working. I am in Florida which has just voted for medical marijuana. I hope the patch will be available here soon.

  13. Beverly says:

    I live in NC and you would think they would rather give you something natural to help with pain then all these pain pills it’s a joke here. I just recently started using cabs e-juice and even though the pain is still here it does help with anxiety and helps to relax for rest I recommend it give it a try helps me and some others I know as for this trial I’m at a point to try anything why not that’s what these Dr.s do always pushing some form of a pill

  14. Tonya Harrell says:

    Live in Mississippi, cannabis use here is illegal. I have fibromyalgia neuropathy, rheumatoid arthritis just to mention a few and I would love to try this new patch maybe someday it will be legal everywhere and we will not have to take all these pills to ease our pain.

    • Tim Bossie says:

      We do hope that you are able to benefit from a patch like this. The pain associated with fibromyalgia needs something like this to help get through the day.

  15. Leila Steele says:

    Thank you for this information. I would like to try the patch. I have been purchasing CBD oil from a dispensary. It is very expensive however it is very effective! I’ve been using the sublingual oils for six months and it has made a huge difference in my daily activities. It’s not a cure for fibromyalgia, but a release from the continual pain. I’ve not tried anything with a higher THC so perhaps that would help more. I still have bad days, today is one, however I know tomorrow will probably be better with CBD. I will be interested in further information as well as trying this. Thank you.

  16. doro fitzgerald says:

    i am in my 70,s have it since 55 it is horrible i have tried this and it does work but too expensive wither way right now for me. dr s have given me pain pills not much help they really dont know or understand the pain and sleepless nights and how tired a person can get. please help me

  17. Cortez D. Distefano says:

    I started using marijuana as a teen. The main reason that kept me using it was the fact that it made my stomach stop hurting. I thought I just had anxiety problems or an ulcer. I have no Idea It’s one of the reason that supress the pain I feel after I read this article from http://www.ilovegrowingmarijuana.com/cbd-in-medical-marijuana/. Since reading is not my thing back then.

    I stopped using it when I was 29. In the four years that I was not using marijuana, I had painful, crampy diarrhea that lasted nearly a year.

    So I figured that if I’m going to use MM therapeutically, I’m going to do it right. Now I’m back with my vaporizer And kicking that chronic pain’s ass.

  18. Babs says:

    My children believe my pain is due to my being 40lbs overweight. I was diagnosed with Fibro 20 yrs ago. The pain is so bad I rather be dead sometimes. Yet my children tell me to eat better, exercise more…. that will cure me! I have tried to lose weight but to exercise one day knocks me out for a week. I will try the patches if I can find them. Medication doesn’t seem to help… this is a last resort….

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