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A 4-year Australian study of 1500 people finds no evidence that cannabis helps to treat pain
Excerpts from above article:
The four-year study of more than 1,500 Australians prescribed opioids for non-cancer pain suggest that there is a need for caution in using medicinal cannabis.
The Pain and Opioids IN Treatment (POINT) study, published today in the journal Lancet Public Health, looked at the effect of cannabis on pain, on the extent to which this interfered with everyday life, and on prescribed opioid use.
In the study, funded by the National Health and Medical Research Council and led by the National Drug and Alcohol Research Centre at UNSW Sydney, participants were recruited through community pharmacies and completed comprehensive assessments of their pain, physical and mental health, medication and cannabis.
Participants had been in pain for a median of 10 years and taken prescribed opioids for for four years. There were very high rates of physical and mental health problems.
At each assessment, participants who were using cannabis reported greater pain and anxiety, were coping less well with their pain, and reported that pain was interfering more in their life, compared to those not using cannabis.
There was no clear evidence that cannabis led to reduced pain severity or pain interference or led participants to reduce their opioid use or dose.
However, the users thought otherwise. Those who used cannabis, despite the study finding no evidence, reported that cannabis was effective (mean score of 7 out of 10).
One possibility is that cannabis improves sleep, which in turn improves well-being, say the researchers.
Pretty much what many of us had strongly suspected. At least in my experience, the ones who were using marijuana were the most likely to be anxious and depressed.
Similar to multiple patients I had seen in residency at a large university hospital pain clinic in the inner city, insisted it helped their pain but refused and fought any decreases in opioid dose. Most often, marijuana was legally prescribed by palliative team. Ultimately the pain clinic told palliative to take over opiate prescribing and management if there was coadministration of prescribed marijuana.
Last conference I had attended, several keynote speakers presents on marijuana for CNP.I suspect most of its benefits are at the level of perception, aka too zonked and sedated to care about their pain. IMO, some weaker evidence at level of modulation.
How does one approach this subject with patients in states where it has been decriminalized when federally it is still a schedule 1 drug? Our approach was always one or the other if they needed management with our pain clinic.
Excerpts from above article:
The four-year study of more than 1,500 Australians prescribed opioids for non-cancer pain suggest that there is a need for caution in using medicinal cannabis.
The Pain and Opioids IN Treatment (POINT) study, published today in the journal Lancet Public Health, looked at the effect of cannabis on pain, on the extent to which this interfered with everyday life, and on prescribed opioid use.
In the study, funded by the National Health and Medical Research Council and led by the National Drug and Alcohol Research Centre at UNSW Sydney, participants were recruited through community pharmacies and completed comprehensive assessments of their pain, physical and mental health, medication and cannabis.
Participants had been in pain for a median of 10 years and taken prescribed opioids for for four years. There were very high rates of physical and mental health problems.
At each assessment, participants who were using cannabis reported greater pain and anxiety, were coping less well with their pain, and reported that pain was interfering more in their life, compared to those not using cannabis.
There was no clear evidence that cannabis led to reduced pain severity or pain interference or led participants to reduce their opioid use or dose.
However, the users thought otherwise. Those who used cannabis, despite the study finding no evidence, reported that cannabis was effective (mean score of 7 out of 10).
One possibility is that cannabis improves sleep, which in turn improves well-being, say the researchers.
Pretty much what many of us had strongly suspected. At least in my experience, the ones who were using marijuana were the most likely to be anxious and depressed.
Similar to multiple patients I had seen in residency at a large university hospital pain clinic in the inner city, insisted it helped their pain but refused and fought any decreases in opioid dose. Most often, marijuana was legally prescribed by palliative team. Ultimately the pain clinic told palliative to take over opiate prescribing and management if there was coadministration of prescribed marijuana.
Last conference I had attended, several keynote speakers presents on marijuana for CNP.I suspect most of its benefits are at the level of perception, aka too zonked and sedated to care about their pain. IMO, some weaker evidence at level of modulation.
How does one approach this subject with patients in states where it has been decriminalized when federally it is still a schedule 1 drug? Our approach was always one or the other if they needed management with our pain clinic.
