More Pain studies with Cannabis

[Sequoiacrone]

In MedPanel Summit, Leading Pain Experts Name Cannabinoids Among Most Promising Approaches to Treating Neuropathic Pain, Assert That Sociopolitical Climate Will Hamper Drug Approvals

Posted on: Wednesday, 21 June 2006, 12:00 CDT
CAMBRIDGE, Mass., June 21 /PRNewswire/ -- Cannabinoids, chemical agents found in the marijuana plant and endogenous to the human body, are the most promising approach to treating a common type of pain, according to an elite group of pain specialists convened by MedPanel to discuss the challenges and future of treating neuropathic (nerve injury) pain. Despite widespread acknowledgement of the inadequacy of current therapies for this type of pain, the specialists view Food and Drug Administration (FDA) approval of a cannabinoid drug as a thorny process that will be hampered by politics, prejudice and a lack of education on the part of the FDA, Drug Enforcement Agency (DEA) and general public concerning the nature of cannabinoid agents. While it is difficult to estimate the number of people suffering from neuropathic pain, the condition is frequently seen in patients with diabetes, cancer, carpal tunnel syndrome, HIV, diseases of the central nervous system such as multiple sclerosis and Parkinson's disease, and in certain post-surgical populations.


for more information see here:
http://www.redorbit.com/news/health/545812/in_medpanel_summit_leading_pain_experts_name_canna binoids_among_most/index.html?source=r_health

[Sequoiacrone]

Cannabis use for chronic non-cancer pain: results of a prospective survey.

ABSTRACT:
There has been a surge in interest in medicinal cannabis in Canada. We conducted a questionnaire survey to determine the current prevalence of medicinal cannabis use among patients with chronic non-cancer pain, to estimate the dose size and frequency of cannabis use, and to describe the main symptoms for which relief was being sought.

Over a 6-week period in mid-2001, 209 chronic non-cancer pain patients were recruited in an anonymous cross-sectional survey. Seventy-two (35%) subjects reported ever having used cannabis. Thirty-two (15%) subjects reported having used cannabis for pain relief (pain users), and 20 (10%) subjects were currently using cannabis for pain relief. Thirty-eight subjects denied using cannabis for pain relief (recreational users). Compared to never users, pain users were significantly younger (P=0.001) and were more likely to be tobacco users (P=0.0001). The largest group of patients using cannabis had pain caused by trauma and/or surgery (51%), and the site of pain was predominantly neck/upper body and myofascial (68% and 65%, respectively).

The median duration of pain was similar in both pain users and recreational users (8 vs. 7 years; P=0.7). There was a wide range of amounts and frequency of cannabis use. Of the 32 subjects who used cannabis for pain, 17 (53%) used four puffs or less at each dosing interval, eight (25%) smoked a whole cannabis cigarette (joint) and four (12%) smoked more than one joint. Seven (22%) of these subjects used cannabis more than once daily, five (16%) used it daily, eight (25%) used it weekly and nine (28%) used it rarely. Pain, sleep and mood were most frequently reported as improving with cannabis use, and 'high' and dry mouth were the most commonly reported side effects


For the entire article:
http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=91

[Sequoiacrone]

The effects of smoked cannabis in painful peripheral neuropathy and cancer pain refractory to opiods.
Author(s)Abrams DI, Jay Ch, Petersen K, Shade S, Vizoso H, Reda H, Benowitz N, Rowbotham M.
Journal, Volume, IssueIACM 2nd Conference on Cannabinoids in Medicine, Cologne, 12-13 September 2003, International Association for Cannabis as Medicine.

Major outcome(s)10 of the 16 participants experienced a greater than 30% reduction in their pain

Abstract
MedicationCannabis

INTRODUCTION: There is significant evidence that cannabinoids may be involved in the modulation of pain, especially of neuropathic origin. There is also theoretical rationale to suggest that cannabinoids may provide synergistic analgesia with opioids while possibly reducing opioid-related side effects. No information is available on potential pharmacokinetic interactions between cannabinoids and opioids.
METHODS: We are currently conducting two clinical trials of smoked marijuana in two populations of patients with pain: HIV patients with painful peripheral neuropathy and cancer patients with persistent pain despite an opioid analgesic. Both studies are designed to begin with a 16 patient open-label pilot proof-of-concept phase. If effectiveness is demonstrated in the pilot, the magnitude of the effect allows us to calculate a follow-on randomized, double-blind controlled trial of smoked marijuana vs smoked placebo. In addition to the effect of smoked marijuana on the subjects’ chronic clinical pain, we are also evaluating the impact on an experimental heat/capsaicin pain model. Here we report experience with the open label phase of the neuropathy study.
RESULTS: Sixteen subjects (14 men, 2 women, mean age 43 years) completed the HIV neuropathy pilot trial. Patients had an average of 6 years of neuropathic pain. In 3 cases the pain was felt to be secondary to HIV alone, in 8 secondary to dideoxynucleoside antiretrovirals and to both in 5. Excellent correlation was seen between the response to smoking in the effect on both the chronic neuropathic and the acute experimental pain model over a six-hour period. Overall 10 of the 16 participants experienced a greater than 30% reduction in their neuropathic pain after seven days. This allowed us to proceed with our currently enrolling randomized placebo-controlled trial with a target sample size of 50 subjects. Additional controlled trials of smoked marijuana for HIV peripheral neuropathy are being conducted by other University of California Center for Medicinal Cannabis Research investigators.
CONCLUSION: Preliminary results from a small, uncontrolled trial of smoked marijuana in HIV peripheral neuropathy are encouraging. The ongoing randomized trials will better elucidate the role of cannabinoids in this condition. A heat/capsaicin experimental pain model appears to be a good predictor of response to chronic pain. The potential of a beneficial clinical interaction between cannabinoids and opioids requires further study.

Source: http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=96