Ron Strider
Well-Known Member
Amid growing concern about opioid addiction, a Canadian researcher studying cannabis for chronic pain relief presented his preliminary results in Halifax Wednesday.
Dr. Jason Busse, McGill University associate professor, told this week’s Canadian Pain Society conference at the Marriot Hotel that early results from a systematic review of medical marijuana show “small but important” pain reduction.
“Current strategies are limited, and clinicians often resort to opioids,” Busse said. “(Medical cannabis) is something that we’re looking at for its potential to treat chronic pain. There is some evidence that it may be effective for some patients.”
On a scale from one to 10 points, with 10 being “pain as bad as possible,” about 12 per cent of patients reported that medical cannabis moved their pain downwards at least one point.
“Another area of interest is whether it can be used as add-on therapy to allow people to come down from some of the opioid medication,” Busse said.
The work is incomplete, he stressed. His team is halfway through analyzing 26 studies that covered 1,915 patients, and his presentation “was an attempt to provide preliminary findings, as part of a larger workshop on the role of medical cannabis in managing chronic pain.
“Now that there’s increasing pressure on patients and physicians to reduce the use of opioids for chronic pain, it’s interesting that there’s at least some preliminary information suggesting that medical cannabis may allow patients to do that.”
The data reviewed included two of the most common adverse events associated with medical marijuana: drowsiness and dizziness, which are likely related to the percentage of THC in a plant strain or cannabis preparation.
“Cannabis is associated with a higher risk of motor vehicle accidents,” Busse said. “It seems obvious that should be considered when people are being prescribed.
“CBD (cannabidiol, one of the dominant components of cannabis) seems to have strong anti-inflammatory properties that may have other roles in possible effects on chronic pain,” Busse said.
“(But) there are a lot of other things in there as well. It’s difficult to know exactly what’s necessary to get the kind of relief that some patients report.”
During systematic reviews, the data from several scientific studies is pooled and compared, so researchers can determine how much confidence to place on the results. In Busse’s current review, uncertainty about CBD remains high because most of the studies included THC as a variable.
The review was funded by a $100,000 grant from the Canadian Institute for Health. As it continues, the team will look to “see whether the treatment effects of medical cannabis are different when you’ve got a combination product,” Busse said.
Unlike opioids and other manufactured pain relievers, cannabis is a plant, Busse noted, which makes it challenging to investigate.
“We can grow strains that have higher or lower levels of THC or CBD, (but) it’s difficult to say at this point the exact chemical composition that is the most effective in dealing with chronic pain while producing the lowest level of undesirable side effects.”
“That said, 26 trials are not bad.
“I think we’re going to be able to say something about different treatment effects, and we’re probably going to be able to extend that, to some degree, to the rate of side effects.”
He said they’re moving on it “pretty quickly” and hope in the next month to have the analysis wrapped up and published sometime this summer.
His review comes after work by a team he co-chaired and that was published earlier this month: The 2017 Canadian Guideline for Opioids for Non-Cancer Chronic Pain, which has already been accepted by the College of Family Physicians of Canada.
“If implemented, it’s likely to reduce prescribing of opioids for chronic pain in Canada,” he said.
A panel of 15 physicians and scientists produced the guide, which discourages opioids as a first-line treatment for chronic pain. The guide also recommends against prescribing opioids when the patient has a current or previous substance-use disorder or other, current psychiatric illness.
“If they pass those thresholds, and a trial of opioids is still being considered, then we recommended staying below 50 mg morphine-equivalent per day, which is quite a bit lower than the recommendation of 200 that came out in 2010,” Busse said. “We’ve made a strong recommendation to stay below 90.
“That’s for patients that have not tried opioids, because guidelines have the potential to compel patients who are currently on opioids, even high doses, to come off or to come down too quickly.
“That can result in opioid withdrawal. Patients may seek opioids from other sources to mitigate the symptoms of withdrawal. There’s an enormous proliferation of illicit fentanyl right now, which is quite dangerous.”
News Moderator: Ron Strider 420 MAGAZINE ®
Full Article: Cannabis eyed as chronic pain reliever | The Chronicle Herald
Contact: Contact Us | The Chronicle Herald
Photo Credit: None Found
Website: The Chronicle Herald
Dr. Jason Busse, McGill University associate professor, told this week’s Canadian Pain Society conference at the Marriot Hotel that early results from a systematic review of medical marijuana show “small but important” pain reduction.
“Current strategies are limited, and clinicians often resort to opioids,” Busse said. “(Medical cannabis) is something that we’re looking at for its potential to treat chronic pain. There is some evidence that it may be effective for some patients.”
On a scale from one to 10 points, with 10 being “pain as bad as possible,” about 12 per cent of patients reported that medical cannabis moved their pain downwards at least one point.
“Another area of interest is whether it can be used as add-on therapy to allow people to come down from some of the opioid medication,” Busse said.
The work is incomplete, he stressed. His team is halfway through analyzing 26 studies that covered 1,915 patients, and his presentation “was an attempt to provide preliminary findings, as part of a larger workshop on the role of medical cannabis in managing chronic pain.
“Now that there’s increasing pressure on patients and physicians to reduce the use of opioids for chronic pain, it’s interesting that there’s at least some preliminary information suggesting that medical cannabis may allow patients to do that.”
The data reviewed included two of the most common adverse events associated with medical marijuana: drowsiness and dizziness, which are likely related to the percentage of THC in a plant strain or cannabis preparation.
“Cannabis is associated with a higher risk of motor vehicle accidents,” Busse said. “It seems obvious that should be considered when people are being prescribed.
“CBD (cannabidiol, one of the dominant components of cannabis) seems to have strong anti-inflammatory properties that may have other roles in possible effects on chronic pain,” Busse said.
“(But) there are a lot of other things in there as well. It’s difficult to know exactly what’s necessary to get the kind of relief that some patients report.”
During systematic reviews, the data from several scientific studies is pooled and compared, so researchers can determine how much confidence to place on the results. In Busse’s current review, uncertainty about CBD remains high because most of the studies included THC as a variable.
The review was funded by a $100,000 grant from the Canadian Institute for Health. As it continues, the team will look to “see whether the treatment effects of medical cannabis are different when you’ve got a combination product,” Busse said.
Unlike opioids and other manufactured pain relievers, cannabis is a plant, Busse noted, which makes it challenging to investigate.
“We can grow strains that have higher or lower levels of THC or CBD, (but) it’s difficult to say at this point the exact chemical composition that is the most effective in dealing with chronic pain while producing the lowest level of undesirable side effects.”
“That said, 26 trials are not bad.
“I think we’re going to be able to say something about different treatment effects, and we’re probably going to be able to extend that, to some degree, to the rate of side effects.”
He said they’re moving on it “pretty quickly” and hope in the next month to have the analysis wrapped up and published sometime this summer.
His review comes after work by a team he co-chaired and that was published earlier this month: The 2017 Canadian Guideline for Opioids for Non-Cancer Chronic Pain, which has already been accepted by the College of Family Physicians of Canada.
“If implemented, it’s likely to reduce prescribing of opioids for chronic pain in Canada,” he said.
A panel of 15 physicians and scientists produced the guide, which discourages opioids as a first-line treatment for chronic pain. The guide also recommends against prescribing opioids when the patient has a current or previous substance-use disorder or other, current psychiatric illness.
“If they pass those thresholds, and a trial of opioids is still being considered, then we recommended staying below 50 mg morphine-equivalent per day, which is quite a bit lower than the recommendation of 200 that came out in 2010,” Busse said. “We’ve made a strong recommendation to stay below 90.
“That’s for patients that have not tried opioids, because guidelines have the potential to compel patients who are currently on opioids, even high doses, to come off or to come down too quickly.
“That can result in opioid withdrawal. Patients may seek opioids from other sources to mitigate the symptoms of withdrawal. There’s an enormous proliferation of illicit fentanyl right now, which is quite dangerous.”
News Moderator: Ron Strider 420 MAGAZINE ®
Full Article: Cannabis eyed as chronic pain reliever | The Chronicle Herald
Contact: Contact Us | The Chronicle Herald
Photo Credit: None Found
Website: The Chronicle Herald
