The use of oral formulations of cannabis and cannabinoids mitigate symptoms in patients with refractory pain, according to the findings of three recent human trials.

In the first study, Australian researchers assessed the use of plant-derived cannabis extract oils over a three-month period in patients suffering from treatment-resistant pain. All participants experienced reductions in their pain impact scores over the course of the trial and a significant percentage of patients also reported improvements in sleep and reductions in fatigue. “Amelioration of the impact of pain confirms continued prescribing of this formulation and validates our observational methodology as a tool to determine the therapeutic potency of medicinal cannabinoids,” researchers concluded.

In the second study, German investigators assessed the efficacy of either a plant-derived cannabis spray containing both THC and CBD (nabiximols) verses oral synthetic THC (dronabinol) as adjunctive treatments in patients with poorly controlled neuropathy. Patients engaged in cannabinoid therapy for 24 weeks. They reported that both treatments “significantly improved pain parameters from baseline and allowed a substantial proportion of patients to reduce their background and rescue pain medication.” However, they noted that study subjects were more likely to discontinue using dronabinol because of adverse events. They concluded, “Treatment with cannabinoids appears to be an effective alternative option for patients with severe neuropathic pain that is poorly responsive to established treatments.”

In the third study, researchers observed the impact of the adjunctive use of dronabinol in a cohort of 1,145 patients with refractory chronic pain. Patients were administered oral THC for 12 weeks. Investigators reported, “Over the 12-week period, 59 percent of patients reported a reduction of other pain treatments and 7.8 percent [had] a complete cessation of any other pharmacological pain treatments.” Authors concluded, “Add-on treatment with DRO [dronabinol] in patients with refractory CP [chronic pain] was well tolerated and associated with a significant improvement.”

Those who consume cannabis medicinally are most likely to report doing so to address chronic pain conditions. Dozens of studies further report that pain patients typically reduce or eliminate their use of opioids following their initiation of cannabis therapy.

Full text of the study, “Medicinal cannabis for the treatment of chronic refractory pain: An investigation of the adverse event profile and health-related quality of life impact of an oral formulation,” appears in Medical Cannabis and Cannabinoids. Full text of the study, “Comparison of the effectiveness and tolerability of nabiximols oromucosal spray versus oral dronabinol as add-on treatment for severe neuropathic pain in real-world clinical practice,” appears in the Journal of Pain Research. Full text of the study, “Effectiveness and tolerability of dronabinol use in patients with chronic pain: A retrospective analysis of 12-week open-label real-world data provided by the German e-registry,” appears in Pain Medicine.

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