Among the overwhelming variety of cannabis products available on the market today, the most effective for pain relief appears to be whole dried marijuana flower and products high in THC, a new study finds.
“Whole cannabis flower was associated with greater pain relief than were other types of products, and higher tetrahydrocannabinol (THC) levels were the strongest predictors of analgesia and side effects prevalence across the five pain categories,” researchers from the University of New Mexico wrote. “In contrast, cannabidiol (CBD) levels generally were not associated with pain relief except for a negative association between CBD and relief from gastrointestinal and non-specified pain.”
Using data from a mobile app that aims to educate users about cannabis products and help them track their experiences, the researchers found that most people who reported self-medicating with marijuana have short-term, yet significant, relief from pain. “In our sample,” they write, “we observed an average pain reduction of roughly 3 points on a standard 0 to 10 visual analogue pain scale, consistent with its application as a mid-level analgesic.”
The findings, published in Complementary Therapies in Medicine in late July, are the latest in a robust body of scientific literature that shows marijuana can help people with different kinds of pain.
The study’s goal was to gauge how the severity of pain changed and what side effects were experienced after cannabis consumption, and whether these effects differed by product. Researchers used information gleaned from Releaf App, a mobile software program developed by three of the study’s authors and released in 2016. The app allows users to monitor their symptoms before, during and after consuming cannabis, thus helping them to understand the differences between products and delivery methods.
The study—which calls the Releaf data set “the largest database of real-time cannabis administration sessions in the U.S”—analyzed 20,513 cannabis sessions recorded in the app by 2,987 people between June 6, 2016 and October 24, 2018.
“Perhaps the most surprising result,” lead author Xiaoxue Li said in a statement, “is just how widespread relief was with symptom relief reported in about 95 percent of cannabis administration sessions and across a wide variety of different types of pain.”
“The results suggest that cannabis flower with moderate to high levels of tetrahydrocannabinol is an effective mid-level analgesic.”
On average, users reported their starting pain to be 5.87 on a scale of 1 to 10. After consuming marijuana, that number fell to 2.77—a decrease of 3.1 points.
“Among the limited number of product characteristics that are typically made available to consumers, we found that consumption of whole, natural Cannabis flower was associated with greater anesthetic potential than were most other types of products,” the authors wrote.
The study also found:
- Patients whose cannabis sessions involved flower reported similar pain relief as those using concentrates and topicals. Edibles, pills and tinctures, however, offered less relief than flower.
- Concentrates were found to be associated with more negative side effects, which the researchers reasoned could be because of solvents and other additives, as well as the removal of most terpenoids, terpenes and flavonoids.
- Products labeled as hybrid strains were more effective at relieving pain than those labeled indica or sativa.
- Combustion method didn’t affect pain.
- Higher THC levels offered more pain relief, while higher CBD levels did not.
- Patients with back, joint or muscle pain, headache or migraine and non-specified pain saw more relief with high-THC products.
- Patients with gastrointestinal/abdominal-related pain found more relief with lower levels of THC.
As for other reactions, patients were more likely to report positive effects than negative effects: they cited dry mouth and feeling foggy as the most common negative ones, while feeling relaxed and peaceful were frequently reported as the most positive ones. Additionally, while CBD levels didn’t impact pain much, the cannabinoid did appear to decrease the likelihood of having negative side effects.
“The current findings,” the study concludes, “show that self-directed medical cannabis treatment, especially among users of higher THC products, is associated with significant improvements in at least short-term pain relief, perhaps a major reason why cannabis has become one of the most widely used medications in the United States.”
In a statement, Jacob Vigil, another study author and UNM associate professor of psychology, said the reason why dried cannabis flower may be more effective for pain is because of its “numerous constituents that possess analgesic properties beyond THC, including terpenes and flavonoids.” These compounds probably work together to increase cannabis’ therapeutic effects, he said.
“Our results confirm that cannabis use is a relatively safe and effective medication for alleviating pain, and that is the most important message to learn from our results,” Vigil continued. “It can only benefit the public for people to be able to responsibly weigh the true risks and benefits of their pain medication choices.”
Photo courtesy of WeedPornDaily.
Hemp-Derived CBD Helps Chronic Pain Patients Reduce Opioid Use, Study Finds
Chronic pain patients consuming hemp-derived cannabidiol, or CBD, on a daily basis for eight weeks reported a decrease in the opioid medications they needed, a new study reports.
“This is a prospective, single-arm cohort study for the potential role of cannabinoids as an alternative for opioids,” the paper states. “The results indicate that using the CBD-rich extract enabled our patients to reduce or eliminate opioids with significant improvement in their quality of life indices.”
The study, published this month in Postgraduate Medicine, sheds new light on the potential benefits of CBD extracted from hemp, a crop that became federally legal under the 2018 Farm Bill, although the Food and Drug Administration has yet to issue finalized guidelines that would allow CBD to be sold in dietary supplements and food products.
Researchers recruited 131 patients who obtain their care from the same pain clinic; 97 completed the eight-week follow-up period. All had been diagnosed with chronic pain and were taking opioid medications for relief.
For the study, participants were given a 60-count bottle of hemp-derived, CBD-rich soft gels. Each gel, according to the study, contained 15.7 mg CBD, 0.5 mg THC, 0.3 mg cannabidivarin, 0.9 mg cannabidiolic acid, 0.8 mg cannabichrome, and less than 1 percent of a botanical terpene blend. Nearly all (91) took two gel caps a day, totaling 30 mg of CBD; three participants opted not to use the hemp extract at all.
“CBD could significantly reduce opioid use and improve chronic pain and sleep quality among patients who are currently using opioids for pain management.”
Researchers asked participants to complete a series of questionnaires to access various factors at the onset of the study, at the four-week mark and at the eight-week point. Among them: their pain intensity level, how much their pain disrupted their lives, the quality of their sleep and how willing they were to cut back on opioids.
Of the total 94 participants who took CBD regularly, 50 reported they were able to reduce opioid medications at week 8. The authors also note: “Additional reductions in polypharmacy on the medication receipt were noted; six participants reported reducing or eliminating their anxiety medications, and four participants reported reducing or eliminating their sleep medication.”
Overall, 89 participants reported their quality of life had improved over the study period. Two measures changed significantly: patients’ self-rating of sleep quality and pain intensity and interference.
At baseline, the study’s authors calculated respondents’ scores regarding sleep quality to an average of 12.09—the higher the score, the poorer the quality of sleep. At the four-week and eight-week check-in points, the score decreased to 10.7 and 10.3, respectively. Similarly, another scale the authors used to measure pain and how it interferes with the enjoyment of life found the mean score value change from 6.5 at baseline to 5.9 at week 4 and 5.7 at week 8.
“The results of this study suggest that using CBD-rich hemp extract oil may help reduce opioid use and improve quality of life, specifically in regards to pain and sleep, among chronic pain patients,” the study concludes. “This is consistent with emerging literature on the topic, which has concluded that CBD is an effective analgesic, and one that helps reduce barriers to opioid reduction, such as physiological withdrawal symptoms.”
In an interview with Appalachian News Express, the study’s lead author Alex Capano said that outside of survey studies, her research is “the largest study on the use of CBD to reduce the use of opioids in the treatment of chronic pain.”
“It’s also the first study on CBD and opioid reduction to identify key data points, such as hemp extract doses, delivery method, and specific cannabinoid content,” she continued. “Most participants used a relatively low dose of 30mg of CBD per day, whereas other studies on CBD have tested very large doses, 10x or 20x that amount. Lower doses of CBD mean reduced risk of side effects and improved outcomes.”
Problematic Marijuana Use Is Declining Among People Who Consume Every Day, Study Finds
Contrary to the expectations of public health experts, the rate of frequent marijuana consumers who are diagnosed with cannabis use disorder (CUD) is not increasing, a new study reports. In fact, it’s actually decreasing, and that may be due to the growing number of states that have legalized access to marijuana.
According to the paper, “CUD prevalence decreased significantly across all ages reporting daily/almost daily cannabis use between 2002-2016. Cannabis dependence prevalence decreased for adolescents and young adults and was stable only among adults ages 26+ reporting daily/almost daily cannabis use.”
Recent studies have had mixed results on the prevalence of CUD—a diagnosis that includes either misuse and/or dependence—in the last two decades. Because people who consume marijuana every day or almost every day are the most at risk for problematic use, researchers at Columbia University’s Mailman School of Public Health set out to get a better understanding of this group’s general health.
Their findings were published last month in the journal Drug and Alcohol Dependence.
The study’s authors used data from the National Surveys on Drug Use and Health for the years 2002-2016. The final sample, totaling 22,651 people, included participants who were 12 and older and reported using marijuana at least 300 days in the past year.
To measure problematic marijuana use, the authors used criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for cannabis dependence and cannabis abuse, such as:
- Spent a great deal of time over a period of a month obtaining, using, or getting over the effects of marijuana
- Unable to keep set limits
- Unable to cut down cannabis use
- Recurrent use resulting in failure to fulfill major role obligations
- Continued use despite persistent or recurrent social or interpersonal problems
Other factors considered in the research asked whether participants had a perceived need for mental health treatment, whether a doctor had indicated they had other health issues and whether or not they’d driven under the influence of illegal drugs with and without alcohol.
Over the study period, the authors found that the prevalence of CUD decreased among their sample in all age groups: For adolescents ages 12 to 17, the rate fell by 26.8 percent; for 18- to 25-year-olds, by 29.7 percent; and for adults 26 and older, by 37.5 percent.
“Among those with past-year daily/almost daily cannabis use, there were reductions in the prevalence of DSM-IV cannabis abuse across all age groups, with reductions observed for all individual abuse items in adolescents and young adults,” the study states. “There were also reductions in the prevalence of DSM-IV cannabis dependence among adolescents and young adults, but not in adults ages 26+. Reductions in most DSM-IV dependence items were observed in young adults while reductions in only a few dependence items were found for adolescents and older adults.”
Researchers offer several possible explanations for the declining rates, many of which point to the influence of legalization. “First, the new national cannabis policy environment, with 33 states legalizing medical use and 10 states allowing recreational use of cannabis may have played a role in reducing stigma and perceptions of risk associated with cannabis use,” Silvia Martins, one of the study’s authors, said in a statement. “Secondly, increasing legalization may also be associated with changes in social attitudes resulting in fewer conflicts with relatives and friends around cannabis use.”
As a result, according to the paper, “[t]his could explain reductions in the abuse item ‘Continued use despite persistent or recurrent social or interpersonal problems,’ which reflects difficulties in interactions with others due to cannabis use.”
It’s also possible that “a sector of the population that is healthier overall” is starting to use marijuana more because of legal access, which “may have diluted the prevalence of cannabis abuse/dependence over time.” They may use “less potent” cannabis or in lower daily amounts, researchers note. Additionally, more people may feel less afraid to admit on a federal survey that they use marijuana frequently.
Ultimately, Martins said, the study’s results “contradict the predominating hypothesis that the prevalence of DSM-IV CUD would be stable, or increase, among those using with this regularity.”
Photo courtesy of Sharon McCutcheon on Unsplash
Marijuana Use Tied To Lower Rates Of Depression And Suicidal Ideation Among PTSD Patients
People suffering from post-traumatic stress disorder (PTSD) who consume marijuana experience significantly fewer depressive episodes and lower rates of suicidal ideation compared to non-users, according to a new study.
The research, published in the Journal of Psychopharmacology on Tuesday, analyzed nationally representative health data from Statistics Canada’s 2012 Community Health Survey and found that people with PTSD who have not reported past-year marijuana use are much more likely to have suicidal thoughts and go through depressive phases.
“This study provides preliminary epidemiological evidence that cannabis use may contribute to reducing the association between post-traumatic stress disorder and severe depressive and suicidal states.”
Among the more than 24,000 people who were eligible for the study, with was conducted by researchers at the the British Columbia Centre on Substance Use and University of British Columbia, 420 were clinically diagnosed with PTSD. Of those, 106 individuals with PTSD (28.2 percent) said they used cannabis in the past year. That’s markedly higher than the average of those who don’t have PTSD (11.2 percent).
“We know that with limited treatment options for PTSD, many patients have taken to medicating with cannabis to alleviate their symptoms,” Stephanie Lake, lead author of the study, said in a press release. “However, this is the first time that results from a nationally representative survey have shown the potential benefits of treating the disorder with cannabis.”
Those suffering from PTSD who didn’t report past-year cannabis use were about seven times as likely to have experienced a recent major depressive episode, the study found. They were also 4.3 times as likely to have contemplated suicide.
“Among cannabis-using respondents, PTSD was not associated with a recent depressive episode or suicide ideation.”
While the study only looked at Canadian respondents, the findings are relevant to U.S. patients as well, as members of the military stateside also experience higher rates of PTSD compared to the general population.
A former secretary of the U.S. Department of Veterans Affairs (VA), David Shulkin, has said recently that he’s in favor of having the department conduct clinical research into the therapeutic benefits of marijuana for veterans with PTSD, stating that the suicide rate among the population demonstrates that ignoring the treatment option comes at the “peril” of service members.
While VA declined to support research initiatives into cannabis for medical conditions that commonly afflict veterans under his leadership, Shulkin said this week that the department “should be involved and should be open to research for anything that will help veterans improve their lives, including medical cannabis.”
“We’re only just beginning to understand what the therapeutic potential of cannabis may be for a variety of health conditions,” M-J Milloy, senior author of the new study, said. “These findings are promising, and merit further study in order to fully understand the benefits of cannabis for people living with PTSD.”
Photo by davide ragusa on Unsplash.