Medicinal Cannabinoids and Chronic Pain
A comprehensive review of studies of medicinal cannabinoid use in chronic pain was commissioned by the Australian Government’s Department of Health. We have used the results of this rigorous work as the source of our summary below.
A team from the University of New South Wales, University of Sydney and University of Queensland under the coordination of the National Drug and Alcohol Research Centre (NDARC) reviewed the available evidence for the use of medicinal cannabis in 5 clinic settings. Their findings for chronic pain, multiple sclerosis and epilepsy are summarised below with particular emphasis on data related to CBD products. The full analysis is available on the Therapeutics Goods Administration (TGA) website which is the Australian Medicines Regulatory body equivalent of Medsafe.
Chronic Pain
Given the burden chronic pain has on patients, it is hardly surprising that there is considerable interest in the potential for medical cannabis to play a role in alleviating symptoms from both patients and clinicians.
In the setting of chronic pain, potential new medicines such as medicinal cannabis need to be considered alongside more established approaches. Active self-management strategies, which generally incorporate a reduction in drug utilisation (particularly high risk opioids) have a proven place in the treatment of chronic pain.
A total of 102 studies examined the impact of medicinal cannabis on patients with chronic pain.
Medicinal Cannabinoids in Pain Summary
A study reviewing all rigorous studies in chronic pain averaging across all medicinal cannabis products showed that medicinal cannabis was more likely than placebo to produce 30% and 50% reductions in pain scores and more likely than placebo to produce a significantly greater reduction in pain intensity ratings. Nabiximols, nabilone and THC extract, when separately examined, were much less consistently superior to placebo in producing a 30% reduction in pain or reducing average pain intensity. The lack of consistency for some individual cannabinoids probably reflects the small number of trials and their small sample sizes.
CBD Specific Data
As of yet, there is little specific data examining the effectiveness of Cannabidiol (CBD) alone in patients with chronic pain. The Australian review highlights two small studies noted below. Clicking on them will retrieve the full text PDF.
Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 ‘N of 1’ studies
Short-Term Efficacy of CBD-Enriched Hemp Oil in Girls with Dysautonomic Syndrome after Human Papillomavirus Vaccination