Low Dose Vaporized Cannabis Significantly Improves Neuropathic Pain – J Pain. 2013 Feb – free full-text PMC article
Even back in 2013, research had already shown that cannabis can be effective for pain relief,.
We conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment.
Thirty-nine patients with central and peripheral neuropathic pain underwent a standardized procedure for inhaling either medium dose (3.53%), low dose (1.29%), or placebo cannabis with the primary outcome being VAS pain intensity
Mixed effects regression models demonstrated an analgesic response to vaporized cannabis.
There was no significant difference between the two active dose groups’ results (p>0.7).
The number needed to treat (NNT) to achieve 30% pain reduction was 3.2 for placebo vs. low dose, 2.9 for placebo vs. medium dose, and 25 for medium vs. low dose
As these NNT are comparable to those of traditional neuropathic pain medications, cannabis has analgesic efficacy with the low dose being, for all intents and purposes, as effective a pain reliever as the medium dos
Psychoactive effects were minimal and well-tolerated, and neuropsychological effects were of limited duration and readily reversible within 1–2 hours.
Vaporized cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain.
Below are excerpts from the final conclusions and discussion. Unlike the usual hype, this article concludes that cannabis is an effective pain management tool and that has some minor and transient dose-dependent side effects.
It’s refreshing to read such a reasonable and sensible study/article about a topic that is, but shouldn’t be, so controversial.
Undesirable consequences of smoking cannabis (i.e., psychological and/or cognitive effects) were identifiable but, consistent with a survey showing that these side-effects are acceptable to patients with chronic pain, no participant withdrew because of tolerability issues.
Subjects receiving active agent endorsed a “good drug effect” more than a “bad drug effect” and the latter was at issue only for the higher dose of cannabis.
Similarly, feeling “high,” “stoned,” or “impaired” were less problematic for the lower strength cannabis.
In general, side effects and changes in mood were relatively inconsequential, and again similar to a survey of cannabis users, many who reported daily treatment with cannabis for chronic pain to be a satisfactory experience.
A reasonable explanation would be that patients self titrate cannabis, balancing analgesia against negative side effects.
Not being well standardized, medicinal cannabis has no mandatory labeling for concentration or purity.
Eventually, the production of cannabis may undergo quality control measures and standardization through regulation and licensure of producers.
Otherwise, purity, concentration and product labeling will not be dependable and quantitative prescribing will not be feasible.
Labeling standards may eventually include warning labels and restrictions,similar to those on tobacco and alcohol products as well as dosages and timing directions.
Finally, someone realizes that cannabis is in the same category of human use as tobacco and alcohol, and should be treated as such.
In this manner, the use of low doses could potentially be prescribed by physicians interested in helping patients use cannabis effectively while minimizing cognitive and psychological side-effects.
Viewed with this in mind, the present study adds to a growing body of literature supporting the use of cannabis for the treatment of neuropathic pain.
It provides additional evidence of
- the efficacy of vaporized cannabis as well as
- establishes low dose cannabis (1.29%) as having a favorable risk-benefit ratio.