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A randomized, double-blinded, placebo controlled
crossover study was conducted in 16 patients with
painful diabetic peripheral neuropathy to assess the
short-term efficacy and tolerability of inhaled
cannabis.
In a crossover design, each participant was exposed
to 4 single dosing sessions of placebo or to low (1%
tetrahydrocannabinol [THC]), medium (4% THC), or
high (7% THC) doses of cannabis.
Baseline spontaneous pain, evoked pain, and
cognitive testing were performed.
Subjects were then administered aerosolized cannabis
or placebo and the pain intensity and subjective
"highness" score was measured at 5, 15, 30, 45, and
60 minutes and then every 30 minutes for an
additional 3 hours.
Cognitive testing was performed at 5 and 30 minutes
and then every 30 minutes for an additional 3 hours.
The primary analysis compared differences in
spontaneous pain over time between doses using
linear mixed effects models. There was a significant
difference in spontaneous pain scores between doses
(P < .001).
Specific significant comparisons were placebo versus
low, medium, and high doses (P = .031, .04, and
<.001, respectively) and high versus low and medium
doses (both P < .001).
There was a significant effect of the high dose on
foam brush and von Frey evoked pain (both P < .001).
There was a significant negative effect (impaired
performance) of the high dose on 2 of the 3
neuropsychological tests (Paced Auditory Serial
Addition Test, Trail Making Test Part B.
This small, short-term, placebo-controlled trial of
inhaled cannabis demonstrated a dose-dependent
reduction in diabetic peripheral neuropathy pain in
patients with treatment-refractory pain. This adds
preliminary evidence to support further research on
the efficacy of the cannabinoids in neuropathic
pain.
A previous study of 2013 demonstrated that the
analgesia obtained from a low dose of
delta-9-tetrahydrocannabinol (1.29%) in patients,
most of whom were experiencing neuropathic pain
despite conventional treatments, is a clinically
significant outcome. In general, the effect sizes on
cognitive testing were consistent with this minimal
dose. As a result, one might not anticipate a
significant impact on daily functioning.
See also
High School students use electronic cigarettes to
vaporize cannabis (2015-09-09)
link...
For more information
Efficacy of Inhaled Cannabis on Painful Diabetic
Neuropathy
Wallace MS, Marcotte TD, Umlauf A, Gouaux B,
Atkinson JH.
J Pain. 2015 Jul;16(7):616-27.
doi: 10.1016/j.jpain.2015.03.008. Epub 2015 Apr 3.
link...
Low-dose vaporized cannabis significantly improves
neuropathic pain
Wilsey B, Marcotte T, Deutsch R, Gouaux B, Sakai S,
Donaghe H.
J Pain. 2013 Feb;14(2):136-48.
doi: 10.1016/j.jpain.2012.10.009. Epub 2012 Dec 11.
link...
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