APS Press Room
News Highlights from The Journal of Pain • June 2008
The Peer Review Journal of the American Pain Society
| For immediate release | Contact: Chuck Weber (847) 705-1802 |
Marijuana May Be Effective for Neuropathic Pain
GLENVIEW, IL, June 25, 2008—The growing body of evidence that marijuana (cannibis) may be effective as a pain reliever has been expanded with publication of a new study in The Journal of Pain reporting that patients with nerve pain showed reduced pain intensity from smoking marijuana.
Researchers at University of California Davis examined whether marijuana produces analgesia for patients with neuropathic pain. Thirty-eight patients were examined. They were given either high-dose (7%), low-dose (3.5%) or placebo cannabis.
The authors reported that identical levels of analgesia were produced at each cumulative dose level by both concentrations of the agent. As with opioids, cannabis does not rely on a relaxing or tranquilizing effect, but reduces the core component of nociception and the emotional aspect of the pain experience to an equal degree. There were undesirable consequences observed from cannabis smoking, such as feeing high or impaired, but they did not inhibit tolerability or cause anyone to withdraw from the study. In general, side effects and mood changes were inconsequential.
It was noted by the authors that since high and low dose cannabis produced equal analgesic efficacy, a case could be made for testing lower concentrations to determine if the analgesic profile can be maintained while reducing potential cognitive decline.
In addition, the authors said 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.
Source: A Randomized, Placebo-Controlled, Crossover Trial of Cannibis Cigarettes in Neuropathic Pain; Barth Wilsey, Thomas Marcotte, Alexander Tsodikov, Jeanna Millman, Heather Bentley, Ben Gouaux and Scott Fishman, University of California Davis
Assessing Motives for Non-Medical Use of Opioids
Drug-use surveys have shown an increasing prevalence of non-medical use of opioid pain medications. University of Chicago researchers writing in The Journal of Pain report that critical information would be learned about the problem if motives for non-medical use were studied more extensively.
Non-medical use of opioids is defined as using a pain medication even once that was not prescribed and was taken only to experience the felling it would cause.
The authors reviewed the three major epidemiological surveys to measure the prevalence of non-medical use of opioids, but focused on the NSDUH (National Survey on Drug Use and Health) survey because it is the largest annual U.S. drug-use survey.
A key drawback the NSDUH survey identified by the authors is the instrument does not probe for motives or reasons for nonmedical use of opioids. For example, pain relief is a motive for using an opioid and so is getting high or inducing sleep.
The authors reviewed results from two web-based surveys, one of which polled 4580 students attending a large Midwestern university. To probe the prevalence of non-medical use of opioids the questionnaire asked: "On how many occasions in a) your lifetime or b) in the last 12 months have you used the following types of drugs not prescribed to you?" Respondents were given eight drug choices. They were then asked to provide the reasons for taking non-prescribed pain medications.
The results showed that lifetime and past 12 month incidence was 14.3 % and 7.5 %, respectively. Most of the respondents (63%) who said they were non-medical users reported that pain relief was the motive. Other common reasons cited were "because it gives me a high" and "experimentation." However, just 40 percent of lifetime non-medical users reported using opioids only to relieve pain.
Based on the web survey results, the authors recommended the NSDUH survey add questions about motives and survey officials should convene a summit with the American Pain Society and other groups to move forward in this direction.
Source: Nonmedical Use of Prescription Opioids: Motive and Ubiquity Issues; James P. Zacny and Stephanie A. Lichtor, University of Chicago