Cannabis Oil Provides ‘Modest’ Pain Relief

By Pat Anson, PNN Editor

Cannabis can be consumed in many different forms for pain relief. You can smoke or vape cannabis flowers, rub cannabis-infused lotions and ointments on your skin, or ingest edibles and beverages containing cannabidiol (CBD) and/or tetrahydrocannabinol (THC), the active ingredients in cannabis.

But it’s cannabis oil that is increasingly cited in research as providing the most benefit for pain sufferers.

The latest study was conducted in Israel, involving about 200 middle-aged adults with chronic pain who were treated by a specialist for at least one year without satisfactory pain relief before trying cannabis. Participants suffered from a variety of pain conditions, including nerve pain, joint pain and headaches. Their average pain level at the start of the study was 7.9 on a zero-to-10 pain scale.

For 6 months, participants ingested cannabis oil extracts daily in a variety of different THC and CBD concentrations, all prescribed by a physician, which were consumed sublingually under the tongue. The doses were considerably lower than what you’d get from smoking or vaping.

By the end of the study, the average pain level among participants had dropped from 7.9 to 6.6, equivalent to a 14% reduction in pain, with similar improvements in sleep, anxiety, depression, disability, and quality of life.

“All these effects are modest in size but are rather consistent and congruent with those found in additional cohorts. Hence, cannabis seems to have an impact on the ‘disease burden’ of chronic pain rather than being a potent analgesic per se,” lead author Dorit Pud, PhD, a Nursing Professor at the University of Haifa, reported in the journal Pain Reports.

‘Taken together, these observational cohorts suggest that in practice, much lower doses of oil extracts of cannabis are used compared with inflorescence (smoking or vaping). It therefore seems that oil extracts may be advantageous over inflorescence as they allow more precise dosing, lower THC dose consumption, and comparable analgesia.”

The number of patients consuming opioids decreased over the course of the study, but because the doses were low and only a minority were taking them, researchers were reluctant to draw conclusions about the opioid-sparing effects of cannabis.

The research team noted that about a quarter of the patients had a 30% or more reduction in pain, but they were unable to determine why these “responders” had better results than others. About half the participants had an adverse side effect from cannabis oil, such as dizziness or confusion, but those symptoms usually declined after the first month.

Previous studies have also found cannabis oil effective in treating pain. Researchers in Columbia say 92% of patients reported less pain after consuming a proprietary formulation of oil containing CBD and THC. Similar findings were reported in a recent study in Australia. Other studies have found cannabis oil effective in treating fibromyalgia and migraine.

UK Study Shows Chronic Pain Patients Benefit from Cannabis

By Pat Anson, PNN Editor

Chronic pain patients who used a variety of cannabis products experienced less pain, better sleep and improved quality of life, according to a new UK study that found the most improvement in patients who used oil-based cannabis products.

Researchers at Imperial College London assessed the safety and efficacy of cannabis in over 700 pain patients enrolled in the UK Medical Cannabis Registry. Participants were divided into three groups that used either oil-based cannabis, smoked or vaporized dried flowers, or a combination of both (CBMP) for six months. The oil-based products included extracts, lozenges and capsules.

The study findings, published in the journal Expert Review of Neurotherapeutics, show symptom improvement in all three groups, with patients using cannabis oil either alone or in combination with dried flower reporting the most improvement.

Researchers think the CBMP group derived the most benefit because the cannabis was ingested through two different administrative routes, one absorbed straight into the blood stream through inhaling (dried flowers) and the other slowly absorbed through the digestive system (oil-based cannabis).

“The findings in this study demonstrate treatment with oil-based, dried flowers, or a combination of both CBMPs are associated with statistically significant improvements in pain relief and sleep quality after 6 months in chronic pain patients,” researchers reported.

“Additionally, patients prescribed oils or both types of CBMPs experienced reduced anxiety and an improvement in their ability to perform daily activities. Patients prescribed a combination of both CBMPs recorded improvements in their self-care and mobility abilities. Collectively, this evidence signals that initiation of CBMP treatment is associated with improved HRQoL (health related quality of life).

In addition to symptom improvement, participants in the CBMP group reported a small reduction (3.28%) in their use of opioid analgesics.

About one in every four patients had an adverse side effect, such as fatigue, somnolence and dry mouth. Adverse events were more common in females, former cannabis users and cannabis naïve (new) users.  

A previous study of patients enrolled in the UK Medical Cannabis Registry found significant improvement in their pain, discomfort and sleep quality after using cannabis oil.

A recent survey of U.S. adults with chronic pain found that nearly a third have used cannabis for pain relief. Over half of those who used cannabis said it also enabled them to decrease their use of opioids and other pain medications.

Study Finds Cannabis Oil Effective in 9 out of 10 Pain Patients

By Pat Anson, PNN Editor

Medical cannabis improved symptoms in 9 out of 10 chronic pain patients taking oral formulations of cannabidiol (CBD) and tetrahydrocannabinol (THC), according to a large new study in Colombia.

The observational study, the largest of its kind in Latin America, is the first clinical peer-reviewed evidence on the effectiveness and safety of cannabis products made by Khiron Life Sciences. Over 2,100 patients with a variety of chronic pain conditions self-reported their symptoms after taking CBD and THC oil-based formulations at a Khiron clinic in Bogota.

The findings are published in the peer-reviewed journal Frontiers in Pain Research.

"We believe these findings to be generalizable across patient populations, considering that our results are extremely well-aligned with those reported by researchers working with similar clinical populations in nations with long-standing medicinal cannabis access programs, such as Israel and Canada," lead author Guillermo Moreno-Sanz, Global Scientific Director of Khiron Life Sciences, said in a press release.

While most previous studies only looked at the short-term effects of cannabis ingested through a variety of different methods, this study focused on the safety and efficacy of cannabis oils for up to 26 weeks. Most participants were female, with an average age of 59 years.

Patients received cannabis oils composed primarily of CBD (30mg CBD/2mg THC) or a more balanced formulation (14mg CBD/12mg THC). 

Key findings in the study include:

• 92.5% of patients reported some degree of improvement in their chronic pain.

• 75% reported moderate or robust reduction in chronic pain

• 72% reported no adverse side effects

The degree of improvement was similar between both formulations, although males reported less effectiveness in the first 4 weeks of treatment.

Most side effects were mild, such as somnolence (13%), dizziness (8%) and dry mouth (4%), and faded away after 12 weeks of treatment. No serious adverse events requiring hospitalization or medical intervention were reported.

"This study, based on Khiron's medical products, is critical to reassure physicians and health insurance providers of the efficacy of medicinal cannabis to treat chronic pain. The global impact and economic burden of chronic pain in our society, mounting medical evidence will increase access to cannabinoid-based medicines worldwide." says Alvaro Torres, Khiron CEO and Director.

Khiron Life Sciences is a medical cannabis company based in Colombia. Its products are sold in Colombia, Peru, Germany, UK and Brazil, and will soon be available in Mexico.

Recent studies have also found cannabis oil effective in treating fibromyalgia and migraine.

Study Shows Cannabis Oil Improves Fibromyalgia Symptoms

By Pat Anson, PNN Editor

A small placebo-controlled trial shows that daily doses of cannabis oil rich in THC (tetrahydrocannabinol) significantly improves pain, fatigue and quality of life in people with fibromyalgia.

The study findings, recently published in the journal Pain Medicine, involved 17 women with fibromyalgia living in Florianopolis, Brazil. Participants were given drops of cannabis oil or a placebo for eight weeks, starting with an initial dose of one drop a day orally and then titrating to an average of 3-4 drops a day.

The cannabis oil used in the study contained 1.22 mg of THC and 0.02 mg of CBD (cannabidiol) per drop. THC is the psychoactive ingredient in marijuana.

The women self-reported their symptoms on a questionnaire every 10 days. Few changes were noted in the placebo group, but the women receiving cannabis oil reported significant improvement on a wide range of symptoms, including pain, depression, anxiety and fatigue. They were also more likely to “feel good” and not miss work compared to the placebo group.

“To our knowledge, this is the first randomized controlled trial to demonstrate the benefit of cannabis oil -- a THC-rich whole plant extract -- on symptoms and on quality of life of people with fibromyalgia,” researchers said. “During the intervention, the impact of the intervention on quality of life in the cannabis group participants was evident, resulting in reports of well-being and more energy for activities of daily living. Pain attacks were also reduced, albeit subjectively, in frequency and intensity.”

The researchers concluded that cannabinoids can be a low-cost and well-tolerated therapy for fibromyalgia patients, and recommended that it be included as an herbal medicine option in Brazil’s public health system.

“The demonstration of safety and efficacy in this gold-standard model is significant. Millions of Americans suffer with FM (fibromyalgia) – a condition that tends to be poorly controlled by standard medicines. These clinical findings indicate that for many of these patients, plant-derived cannabis preparations may be a safe and effective alternative,” said Paul Armentano, Deputy Director of NORML, a pro-marijuana advocacy group.

A major weakness of the Brazilian study is its small size. Participants also continued to self-medicate with analgesics and anti-inflammatory medications during the study, which could have affected the findings.

A larger 2019 study in Israel also found that cannabis reduces pain and improves quality of life for fibromyalgia patients. The cannabis used in that study was ingested by tincture, oil or vaporizer.