Cannabis works for back pain, in new studies: shots

Should I try cannabis for my back pain?

That’s a question for the spine surgeon Richard Price says he gets patients coming to his clinic at least several times a day.

When Price finally dove into the evidence A few years ago he realized that there weren’t many high-quality studies, although chronic pain is one of them most common reasons People are turning to medical marijuana.

“Anecdotal, [people] “They say cannabis works great,” says Price, an assistant professor of neurological surgery at UC Davis. “It’s the only thing that helps them sleep at night, the only thing that takes their nerves away.”

For this reason, results were obtained from two large clinical trials in Europe examining cannabis for lower back pain main cause of disabilities worldwide — have caught the attention of Price and others who are studying the plant’s potential in treating pain.

The first, published in the magazine Natural medicine, showed that A mixture of cannabis oil containing the psychoactive compound THC as well as CBD and other natural compounds in the plant outperformed a placebo.

The other compared the same proprietary cannabis tincture to opioids. There were patients here much less likely Gastrointestinal side effects such as constipation and cannabis provided better relief than her pain medications for 6 months.

Price believes the new studies are “groundbreaking” and will be a “cornerstone” of the growing evidence base on cannabis and chronic pain.

Because cannabis remains a Schedule 1 drug – a category reserved for substances without recognized medical use – and is highly regulatedthis type of large-scale clinical trials is hard be successful in the USA

Vertanical, the German company that funded the studies, expects to receive approval to market its full-spectrum cannabis oil, called VER-01, to patients in several European countries in a few months.

Meanwhile, the Food and Drug Administration wants the company to repeat that research in the U.S., meaning it could be years before the drug has a chance of approval here.

“If politicians or the FDA want to speed up the process, we are ready,” he says Clemens Fischerthe founder of Vertical.

The FDA declined to comment on the future of VER-01, but a spokesperson told NPR in a statement that it supports “rigorous, science-based research to evaluate these products.”

An alternative for pain relief

The results of the European studies were “remarkable”, particularly the fact that cannabis outperformed opioids in terms of pain relief and sleep, it said Kevin Böhnkea Assistant professor of anesthesiology at the University of Michigan who studies cannabis and chronic pain.

The opioid study involved nearly 400 participants – about half the size of the other study comparing cannabis and a placebo – and patients knew which drug they were receiving.

Although these are limitations, Boehnke says the study also better reflected the real world and confirms previous research that suggests “many people intentionally use cannabis instead of opioids” because they find it more effective and don’t experience the same side effects.

While Vertanical’s cannabis tincture may not be available in the U.S. any time soon, Boehnke said the study suggests that it may be worth trying a similar cannabis product instead of opioids for people seeking treatment for lower back pain.

“Maybe it’s not exactly the same,” he says. “But I think this provides a lot of useful evidence for patients.”

However, others in the field are more cautious.

“This is the kind of in-depth study that is desperately needed,” he says Simon Haroutounianwho has decades of experience in this field and leads research at the Washington University Pain Center in St. Louis.

However, he believes the results are specific to this particular compound tested.

In the study, participants in the cannabis group had an average decrease in pain of about 30% after 12 weeks compared to their baseline. Meanwhile, those taking the placebo experienced a reduction of about 20%.

Haroutounian says the real treatment effect likely lies in the difference between the two.

Another way to look at effectiveness is that the number of people who need to take the drug to get clinically meaningful pain relief is about seven.

“Most of the medications we have available to treat chronic pain are in this range,” says Haroutounian. “So it’s not a panacea, it’s not an active ingredient that can treat all chronic pain.”

Proponents of medical cannabis are quick to point out that the drug’s safety profile is clearly positive. Unlike opioids, there are not the same concerns about overdose and addiction.

Vertical’s Fischer notes that there were no signs of dependence or withdrawal. In fact, he said participants typically didn’t feel high, especially if they had taken it for a long period of time.

“You’re not stoned,” he says. “They go to work, they drive cars, they use machines, everything that is possible and legal in Europe.”

However, in the study, those taking opioids and cannabis experienced roughly the same side effects, and about 13% ultimately dropped out of the study.

Over the years, Haroutounian, a clinical pharmacist, has seen successes and failures with his own patients.

A patient had suffered a horrific motorcycle injury and ended up having to taper off opioids with the help of cannabis. On the other hand, he remembers the case of an elderly woman who tried cannabis for knee pain.

“The first dose made her dizzy. She fell and broke her hip,” he says. “She spent the next six months in and out of the hospital.”

Pain sufferers want cannabis options

There is currently only one medicine derived from cannabis with FDA approvalthe seizure medication Epidiolex, and it does not contain THC.

Although it’s not entirely clear, experts like Boehnke say THC appears to be one of the “main” compounds responsible for relieving pain and improving sleep.

“There is no panacea for chronic pain, virtually nothing,” he says. “A lot of times it’s like, ‘Oh, I benefited a little bit here and there,’ and then you sort of put the puzzle together.”

However, most Americans also live in a state where marijuana is legal Recreational or medicalthere are well-documented concerns about the Quality and consistency of these products.

Ellen Lenox Smithwho is affiliated with the US Pain Foundation, says FDA approval of a cannabis product would not only make it available in all states, but would also give patients with chronic pain confidence in what they are using.

“I wish it was our country that was putting this out now,” she says.

As a patient advocate, she is frustrated that there is no better research to point others to.

“It’s unfortunate because a lot of people are kind of on their own,” says Lenox Smith, who has used medical marijuana to treat her own pain for nearly two decades.

Her condition, known as Ehlers-Danlos syndrome, has led to more than two dozen surgeries, including on the neck and spine. Still, a spoonful of her homemade cannabis oil gives her relief and helps her sleep through the night.

UC Davis surgeon Richard Price thinks this is a reasonable option for his patients who don’t need surgery. However, he wants the findings from Europe to be replicated in the US before promoting cannabis more broadly.

“It’s really challenging to tell someone, ‘I know you’re in pain, but there’s nothing I can do for you, and many patients don’t want to take opioids,'” he says.