AHRQ Review Evaluates Cannabis Products Containing THC and CBD for Pain Relief

PainRelief.com Interview with:
Roger Chou, MD
Professor of Medical Informatics and Clinical Epidemiology, School of Medicine
Professor of Medicine, School of Medicine
2012-present Director, Pacific Northwest Evidence-based Practice Center
Medical Informatics and Clinical Epidemiology, School of Medicine
Oregon Health & Science University
Portland, Oregon

PainRelief.com: What is the background for this study?

Response: We started this review five years ago, it was funded by the Agency for Healthcare Research and Quality (part of the Department of Health and Human Services). Because there is a lot of interest in use of cannabis products for pain and because new research is coming out, we planned to do it as a “living” review, which means that instead of reviewing all the studies at one point of time and publishing the findings and then being done, we continually searched for new studies and updated our analyses as they became available. We conducted this review over 5 years and this article reports the final findings of the review.

An important thing to know is that cannabis products are complicated because cannabis contains different chemicals that are thought to have different properties, the most important being THC and CBD.  THC is considered the psychoactive component and CBD isn’t thought to have psychoactive properties but may have medical or therapeutic properties.  Different cannabis products (as well as the plants themselves) vary in how much THC or CBD is contained, ranging from “pure” THC or CBD to mixed products.  We separated cannabis products into different categories based on the amount of THC relative to CBD, which is important because the benefits or harms may vary according to how much THC or CBD is present.  We also looked at whether the products were taken from the plant or made in a lab (synthetic) as well as how the products were taken (e.g., a capsule or cream/oil or spray etc) which can all impact how the products work.

UCSD Study Evaluates Self-Treatment with Cannabis for Migraine

PainRelief.com Interview with:

Nathaniel M. Schuster, MD
Pain and Headache Neurologist
Associate Professor
Center for Pain Medicine
Department of Anesthesiology
UC San Diego Health

Schuster, Nathaniel, MD, Pain Medecine

PainRelief.com: What is the background for this study?

Response: Many Americans self-treat migraine with cannabis. It is one of the most common reasons Americans use medicinal cannabis.

PainRelief.com: What are the main findings?

Response: The main finding is that 4 puffs of THC 6%+CBD 11% was effective for migraine pain relief, pain freedom, and most bothersome symptom freedom at 2 hours. 

THC 6% without CBD provided pain relief but not pain freedom or most bothersome symptom freedom and performed less-well than THC+CBD at numerous outcomes.

Cannabis for Chronic Pain Linked to Increased Risk of Arrhythmia

PainRelief.com Interview with:
Anders Holt
Department of Cardiology
Copenhagen University Hospital—Herlev and Gentofte
Gentofte Hospitalsve
Hellerup, Denmark
Department of Epidemiology and Biostatistics
School of Population Health, University of Aucklan
Auckland, New Zealand

PainRelief.com: What is the background for this study?


cannabis-marijuana

Response: The motivation for this study was the fact that medical cannabis is being made available as medical treatment for chronic pain in an increasing number of countries worldwide. Meanwhile, robust evidence on possible cardiovascular side-effects is very scarce. This could be worrisome since recreational cannabis previously have been associated with an elevated risk of arrhythmia and acute coronary syndromes.

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Rutgers Study Finds Modest Decrease in Non-Prescription Opioid Use with Cannabis Legalization, But Concentrated in People Addicted to Cannabis

PainRelief.com Interview with:
Hillary Samples, PhD, MHS
Assistant Professor of Health Systems and Policy
Rutgers School of Public Health
Core Faculty
Center for Pharmacoepidemiology and Treatment Science

Rutgers Institute for Health, Health Care Policy and Aging Research
New Brunswick, NJ 08901

PainRelief.com: What is the background for this study?

Response: Early studies suggesting that cannabis legalization is associated with lower rates of opioid-related harms received considerable media attention. At the time, overdose deaths were driven by prescription opioids, and medical cannabis was often framed as a policy approach to address the opioid epidemic. However, as research in this area grew, the relationship between medical cannabis legalization and opioid-related harms became less clear. Many studies of cannabis legalization were unable to examine opioid use by individual people, and individual-level studies outside the legal context showed links between cannabis use and higher risk of opioid-related harms. Thus, our goal was to build evidence of the relationship between medical cannabis legalization and individual-level opioid use.

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WashU Study Surveys Cannabis Use for Sleep

PainRelief.com Interview with:
Carrie Cuttler, Ph.D.
Associate Professor
The Health & Cognition (THC) Lab
Department of Psychology
Washington State University

PainRelief.com: What is the background for this study?

Response: We know that one of the top 5 reasons cannabis users report using cannabis is for sleep disturbances, but we don’t know very much about the types of products they prefer to use for sleep or their perceptions of its effects and side effects relative to more conventional sleep aids (e.g., benzodiazepines, antihistamines, melatonin).

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CAMH Study Finds Potential Risks to Baby from Cannabis Exposure During Pregnancy

PainRelief.com Interview with:
Maryam Sorkhou
PhD student at the Institute of Medical Sciences
University of Toronto

PainRelief.com: What is the background for this study?

Response: While studies on animals strongly suggest that exposure to cannabis during pregnancy can affect brain development, the impact of using cannabis during pregnancy in humans is not yet clear. Some studies suggest potential negative effects, while others find no impairments.

In light of increasing trends towards legalization and potentially decreased perceptions about the risks of cannabis, our meta-analysis of 57 studies aimed to fill this gap by exploring the associations between prenatal cannabis use and birth and childhood outcomes.

Cannabis-Related Hospitalizations Following Legalization in Canada

PainRelief.com Interview with:
Daniel Myran, MD, MPH, CCFP, FRCPC
Canada Research Chair, Social Accountability, University of Ottawa
Investigator, Bruyère Research Institute 
Assistant Professor, Department of Family Medicine
Lecturer, School of Epidemiology and Public Health
Adjunct Scientist, ICES
University of Ottawa

PainRelief.com: What is the background for this study?

Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Legalization in Canada took a phased approach initially, only the sale of flower-based cannabis products and oils was permitted and there were very few legal cannabis stores and legal sales. Starting in early 2020, Canada allowed the sale of expanded products (e.g. cannabis edibles, vape pens, concentrates), and the number of retail stores began expanding. In this study, we took advantage of this evolution of the legal cannabis market to understand how different phases of legalization were associated with hospitalizations due to cannabis.  

Canadian Study Finds Cannabis Use Disorder Associated with Higher Risk of Heart Disease

PainRelief.com Interview with:
Anees Bahji, BSc(H), MD, CISAM, CCSAM, DABPN, FRCPC (pronouns: he/him/his)
Clinical Assistant Professor, Department of Psychiatry, University of Calgary
Ph.D. Student, Department of Community Health Sciences, University of Calgary
Addiction, Concurrent Disorder, and General Psychiatry
Opioid Dependency Program, Sheldon M. Chumir Centre
Rapid Access to Addiction Medicine Service, Calgary
Adult Addiction Centre, 6th Floor, Foothills Medical Centre

PainRelief.com: What is the background for this study?

Response: The background for this study is rooted in the need to understand the potential health implications of cannabis use disorder (CUD), especially in relation to cardiovascular health.

Cannabis has become increasingly popular for both recreational and medicinal purposes, and it is essential to assess its impact on various health outcomes.

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Study Assesses Quality of Life After Cannabis Prescribed for Chronic Pain and Other Health Symptoms

PainRelief.com Interview with:
Margaret-Ann Tait | PhD candidate
Project Manager, The QUEST Initiative
Research Manager, Faculty of Medicine and Health
Sydney Nursing School, Cancer Care Research Unit
University of Sydney

PainRelief.com: What is the background for this study?

Response: In 2016 Australia passed legislation that allows cannabis use for medicinal purposes. Since then, an estimated 800,000 patients have received medicinal cannabis prescriptions. We wanted to know if patients with chronic health conditions in Australia are reporting their health outcomes differently after being prescribed medicinal cannabis. We used validated questionnaires to assess their health-related quality of life, levels of fatigue, pain, sleep disturbance, anxiety, and depression before starting therapy and then at regular intervals for three months after. 

We had 2327 patients participating from across Australia aged between 18 and 97 (the average age was 51), and nearly two thirds were female. Half of our participants were prescribed medicinal cannabis for more than one condition, with chronic pain conditions reported more frequently, followed by insomnia, anxiety, and mixed anxiety & depression.

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Cannabis Use May Expose Users to Lead and Cadmium

PainRelief.com Interview with:
Tiffany R. Sanchez, PhD (she/her)
Assistant Professor
Environmental Health Sciences 
Columbia University Mailman School of Public Health

PainRelief.com: What is the background for this study?

Response: We’ve known that the cannabis plant is good at accumulating metals, like lead and cadmium, and long-term exposure to these metals carry important health risks. What was unclear before our study was whether or not people who use cannabis actually have higher metal levels in their body compared to non-users.

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