Smoked Marijuana For Chronic Neuropathic Pain

Monterey Bud · Jan 4, 2013

Mark A. Ware MBBS, 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

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)

Source - CMAJ

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Smoked Marijuana For Chronic Neuropathic Pain

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