Onset Of Pain Associated With Chemotherapy Drugs Could Be Prevented With Cannabidiol

A chemical component of the marijuana plant, cannabidiol, may prevent the onset of pain associated with drugs used in chemotherapy, particularly in breast cancer patients, according to researchers at Temple University’s School of Pharmacy.

The researchers published their findings, “Cannabidiol Prevents the Development of Cold and Mechanical Allodynia in Paclitaxel-Treated Female C57Bl6 Mice,” in the journal Anesthesia and Analgesia.

Animal models were developed by the researchers who tested ability of the compound (that is the second-most abundant chemical found in the marijuana plant) for relieving hemo-induced neuropathic pain, said Sara Jane Ward, research assistant professor of pharmaceutical sciences in Temple’s School of Pharmacy and the study’s lead author.

“We found that cannabidiol completely prevented the onset of the neuropathic, or nerve pain caused by the chemo drug Paclitaxel, which is used to treat breast cancer,” said Ward, who is also a research associate professor in Temple’s Center for Substance Abuse Research.

One of cannabidiol’s major benefits is that it does not produce psycho-active effects such as euphoria, increased appetite or cognitive deficits, said Ward. “Cannabidiol has the therapeutic qualities of marijuana but not the side effects,” she said.
The research of Ward has long focused on brain systems that are impacted by marijuana and whether those systems may be targeted in the treatment of various disorders. “Marijuana binds to the cannabinoid receptors in the body and researchers have long been interested in whether there is therapeutic potential for targeting this receptor system,” she said.

Ward also said cannabidiol has also demonstrated the ability for reducing tumor activity in animal models that may make it an effective therapeutic for breast cancer, especially if you “combined it with a chemo agent like Paclitaxel, which we already know works well.”
There are about 10 clinical trials underway according to Ward in the United States for cannabidiol on a range of different disorders, including cannabis dependence, eating disorders and schizophrenia. Because of this, Ward believes that it would be easier to establish a clinical trial for cannabidiol as a therapeutic against neuropathic pain associated with chemo drugs.

Reference:
Temple University

Pain Significantly Reduced In Trials By Marijuana

According to a systemic review of randomized controlled trials published in the British Journal of Clinical Pharmacology, cannabis inhalation and the administration of cannabinoids are both associated with “significant analgesic effects” in the treatment of chronic non-cancer pain.

A literature review regarding the efficacy of cannabinoids in the treatment of chronic pain, including neuropathic pain, fibromyalgia, rheumatoid arthritis, and mixed chronic pain was conducted by investigators from the University of Toronto, Hospital for Sick Children. Eighteen randomized controlled trials that were published between 2003 and 2010 involving a total of 766 participants met inclusion criteria. For of the trials evaluated inhaled cannabis, while other studies assessed the analgesic properties of either plant-derived cannabinoids or synthetic cannabinoids.

“Overall the quality of trials was excellent,” authors wrote. “Fifteen of the eighteen trials that met inclusion criteria demonstrated a significant analgesic effect of cannabinoid as compared to placebo, several reported significant improvements in sleep. There were no serious adverse effects.”

It was noted by the researchers that all four trials involving inhaled cannabis “found a positive effect with no serious adverse side effects.” They added: “Of special importance is the fact that two of the trials examining smoked cannabis demonstrated a significant analgesic effect in HIV neuropathy, a type of pain that has been notoriously resistant to other treatments normally used for neuropathic pain. In the trial examining cannabis based medicines in rheumatoid arthritis a significant reduction in disease activity was also noted, this is consistent with pre-clinical work demonstrating that cannabinoids are anti-inflammatory.”

Investigators concluded, “[C]annabinoids are a modestly effective and safe treatment option for chronic non-cancer (predominantly neuropathic) pain. Given the prevalence of chronic pain, its impact on function and the paucity of effective therapeutic interventions, additional treatment options are urgently needed. More large-scale trials of longer duration reporting on pain and level of function are required.”

Reference:
Cannabinoids for treatment of chronic non-cancer pain; a systemic review of randomized trials-British Journal of Pharmacology

Marijuana The Reliever Of Pain

A team from Canada has found that three puffs of cannabis (also known as marijuana) a day could be helpful for people with chronic nerve pain because of surgery or injury to feel less pain and sleep better.

“It’s been known anecdotally,” says researcher Mark Ware, MD, assistant professor of anesthesia and family medicine at McGill University in Montreal. “About 10% to 15% of patients attending a chronic pain clinic use cannabis as part of their pain [control] strategy,” Ware remarked.

The study of Ware is more scientific in nature as it was a clinical trial in which his team compared placebo with three different cannabis doses. The study “adds to the trickle of evidence that cannabis may help some of the patients who are struggling [with pain] at present,” Henry McQuay, DM, an emeritus fellow at Balliol College, Oxford University, England, writes in a commentary accompanying the study.

Twenty-one men and women, with an average age of 45 years, were evaluated by Ware and his team. All of the 21 people had chronic nerve pain (or neuropathic pain). Three different potencies of marijuana were tried by the team of Ware and the highest of all concentrations was at 9.4% tetrahydrocannabinol (THC) herbal cannabis, the other two being 2.5% and 6% THC.

“Each person was in the study for two months, and used all four strengths [including placebo],” Ware says.

The participants were allowed to continue on their routine pain medications and all took a single puff of marijuana three times a day for five days for each of the doses and the placebo. Participants rated their pain on a scale of zero to 10, with 10 being the worst after each of the five-day trials.

Ware said the highest dose (9.4%) offered relief and reduced their pain down to 5.4, compared to 6.1 from placebo. “We’ve shown again that cannabis is analgesic,” Ware says. “Clearly, it has medical value.”

The research is published in CMAJ, the Canadian Medical Association Journal.

Cannabis influences blood levels of appetite hormones in HIV patients

Scientists of the Center for Medicinal Cannabis Research (CMCR) of the University of California in San Diego, USA, have investigated among others the effects of cannabis on appetite hormones in the course of a placebo-controlled trial with HIV patients, who suffered from pain.

Twenty-eight patients had been included to investigate the effects of smoked cannabis on their pain in the original already published clinical study. Seven of these patients selected for investigating the blood levels of the hormones leptin, ghrelin, peptide YY, and insulin after exposition with cannabis and placebo in a cross-over design.

Cannabis administration, compared to placebo, was associated with significant increases in plasma levels of ghrelin and leptin, and decreases in peptide YY. It however did not significantly influence insulin levels. Authors stated that “cannabis-related changes in these hormones had a magnitude similar to what has been observed with food intake over the course of a day in normal volunteers, suggesting physiological relevance. “They concluded that “these findings are consistent with modulation of appetite hormones mediated through endogenous cannabinoid receptors, independent of glucose metabolism.”

Reference:

Riggs PK, Vaida F, Rossi SS, Sorkin LS, Gouaux B, Grant I, Ellis RJ. A pilot study of the effects of cannabis on appetite hormones in HIV-infected adult men. Brain Res. 2011 Nov 7. [in press])

Marijuana Eases Nerve Pain

Smoking Pot Could Ease Nerve Pain

medicalmarijuanapainSmoking pot may ease nerve pain at the expense of certain mental skills, according to a research on medical marijuana.

This finding was revealed by researchers at the University of California in an edition of The Journal of Pain.

The researchers studied 38 adults afflicted with nerve pain (neuropathic pain) and who smoked pot in the past but abstained from smoking marijuana for a period of thirty days before the study. The study participants visited lab of the researchers thrice and smoked a marijuana cigarette made for research purposes, under the National Institute of Drug Abuse’s supervision.

Participants rated their pain before and after smoking their assigned cigarette. There was more of drop in pain ratings after smoking the THC cigarettes than the placebo cigarette lacking THC. Comparable effects were noticed with higher doses and lower doses and these effects began to wear off an hour or two after they stopped smoking. The study showed participants had no change in their pain sensitivity to light touch or heat after smoking any of the cigarettes.

Researcher Barth Wilsey, MD, and colleagues urged “caution in the prescribing of medical marijuana for neuropathic pain,” especially in light of the mental impact, and also in young patients, as pot use in adolescence “increases the risk of later schizophrenia-like psychoses, especially in genetically susceptible individuals.”

References:
Wilsey, B. The Journal of Pain, June 2008; vol 9: pp 506-521

Reduced Pain Intensity From Smoking Marijuana

kill-pain-hempThe growing body of evidence that marijuana, also known as cannabis, could be effective as a pain reliever has been expanded with publication of a new study in The Journal of Pain. The study reported that patients with nerve pain showed reduced pain intensity from smoking marijuana.

Researchers at University of California Davis evaluated whether marijuana produces analgesia for patients with neuropathic pain. For this, 38 patients were examined and given high-dose (7%), low-dose (3.5%), or placebo cannabis.

It was reported by the authors that identical levels of analgesia were produced at each cumulative dose level by both concentrations of the agent and cannabis reduced the core component of nociception and the emotional aspect of the pain experience to an equal degree.

The authors noted that a case could be made for testing lower concentrations to determine if the analgesic profile can be maintained while reducing potential cognitive decline, since high and low dose cannabis produced equal analgesic efficacy. The authors added that further research could probe whether adding the lowest effective dose of cannabis to another analgesic drug might lead to more effective neuropathic pain treatment for patients who otherwise are treatment-resistant.

A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain.
Wilsey B, Marcotte T, Tsodikov A, Millman J, Bentley H, Gouaux B, Fishman S.

J Pain. 2008 Jun;9(6):506-21. Epub 2008 Apr 10.

VA Northern California Health Care System, Department of Anesthesiology and Pain Medicine, University of California, Davis Medical Center, Davis, California, USA.

Abstract:

The Food and Drug Administration (FDA), Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institute for Drug Abuse (NIDA) report that no sound scientific studies support the medicinal use of cannabis. Despite this lack of scientific validation, many patients routinely use “medical marijuana,” and in many cases this use is for pain related to nerve injury. We conducted a double-blinded, placebo-controlled, crossover study evaluating the analgesic efficacy of smoking cannabis for neuropathic pain. Thirty-eight patients with central and peripheral neuropathic pain underwent a standardized procedure for smoking either high-dose (7%), low-dose (3.5%), or placebo cannabis. In addition to the primary outcome of pain intensity, secondary outcome measures included evoked pain using heat-pain threshold, sensitivity to light touch, psychoactive side effects, and neuropsychological performance. A mixed linear model demonstrated an analgesic response to smoking cannabis. No effect on evoked pain was seen. Psychoactive effects were minimal and well-tolerated, with some acute cognitive effects, particularly with memory, at higher doses. PERSPECTIVE: This study adds to a growing body of evidence that cannabis may be effective at ameliorating neuropathic pain, and may be an alternative for patients who do not respond to, or cannot tolerate, other drugs. However, the use of marijuana as medicine may be limited by its method of administration (smoking) and modest acute cognitive effects, particularly at higher doses.

References:
American Pain Society (2008, June 29),

Marijuana Could Be Effective For Neuropathic Pain

According to a new study in The Journal of Pain, patients with nerve pain showed reduced pain intensity from smoking marijuana. The report has expanded the growing body of evidence that marijuana could be effective as a pain reliever.

Researchers at University of California Davis evaluated whether marijuana produces analgesia for patients with neuropathic pain. Thirty-eight patients were examined and administered with high-dose (7%), low-dose (3.5%) or placebo cannabis.

pain-marijuana-relief

It was reported by authors that identical levels of analgesia were produced at each cumulative dose level by both concentrations of the agent. Cannabis, as with opioids, does not rely on a relaxing or tranquilizing effect but minimizes the core component of nociception and the emotional aspect of the pain experience to an equal degree. The smoke of cannabis leads to undesirable consequences such as feeling high or impaired but it does not inhibit tolerability or cause anyone to withdraw from the study.

The authors also noted that since high and low dose cannabis produced equal analgesic efficiency, a case may be made to test lower concentrations for determining if the analgesic profile can be maintained while reducing potential cognitive decline. The authors said further research could probe whether adding the lowest effective dose of cannabis to another analgesic drug may lead to effective neuropathic pain treatment for patients who otherwise are treatment-resistant.

Reference:
Barth Wilsey, Thomas Marcotte, Alexander Tsodikov, Jeanna Millman, Heather Bentley, Ben Gouaux and Scott Fishman. A Randomized, Placebo-Controlled, Crossover Trial of Cannibis Cigarettes in Neuropathic Pain. The Journal of Pain, (in press)