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Study: Chronic Pain Patients Report Improved Quality of Life Following Medical Cannabis Use

Philadelphia, PA: Patients with chronic pain conditions report improvements in their health-related quality of life following the use of cannabis, according to data published in the journal Medical Cannabis and Cannabinoids.

Investigators assessed the use of cannabis in a cohort of 181 pain patients enrolled in Pennsylvania’s medical marijuana access program. Participants were surveyed at baseline and then again at two, four, and eight weeks.

During the course of the study, subjects experienced “a significant improvement in both pain scores and HRQoL [health-related quality of life.]” Patients also demonstrated “significant improvements” in managing their anxiety.

Authors concluded, “The results of this study show that MM[medical marijuana], when used for the treatment of pain, can be beneficial at improving a patient’s QoL [quality of life] along with alleviating their pain.”

Several gold-standard human trials show that cannabis can alleviate pain in various patient populations, including those with HIV, diabetes, spinal cord injury, and with treatment-resistant neuropathy (nerve pain). A 2017 review of over 10,000 peer-reviewed scientific papers by the National Academies of Sciences, Engineering, and Medicine acknowledged, “In adults with chronic pain, patients who [are] treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms. … There is conclusive or substantial evidence that cannabis is effective for the treatment of chronic pain in adults.”

Numerous observational studies also consistently report that the initiation of medical cannabis is associated with self-reported improvements in patients’ quality of life, particularly among elderly subjects.

Full text of the study, “Measuring the change in health-related quality of life in patients using marijuana for pain relief,” appears in Medical Cannabis and Cannabinoids.

Daily Marijuana Consumers Exhibit Insignificant Changes in Simulated Driving Performance After Smoking

Aurora, CO: Daily cannabis consumers display insignificant changes in simulated driving performance compared to non-users following marijuana inhalation, according to data published in the journal Accident Analysis and Prevention.

A team of researchers affiliated with the University of Colorado assessed driving simulator performance among subjects with a history of daily cannabis use, occasional cannabis use, and no history of current use. Consumers inhaled cannabis ad libitum over a 15-minute period and then engaged in simulated driving 30-minutes later. Investigators explicitly assessed consumers’ abilities to maintain lateral positioning and to maintain a specific rate of safe speed as compared to non-users.

Those with a history of occasional cannabis use exhibited a significant increase in SDLP (standard deviation in lateral positioning) following cannabis inhalation. Occasional users also drove faster than non-users, but not to a degree that reached statistical significance. By contrast, daily users displayed insignificant changes in SDLP following cannabis inhalation and drove at slightly slower speeds.

Authors reported: “In this study of the acute effects of cannabis use on driving performance among participants with a history of using cannabis daily or occasionally, we found evidence for decrements of driving performance in both groups relative to baseline for SDLP, that was of moderate size and statistical significance only in the occasional users. Small, statistically significant decreases in speed were observed in the daily use group.”

The findings are consistent with prior driving performance studies showing that acute cannabis exposure may influence SDLP performance and that more habitual consumers become tolerant to marijuana’s effects on psychomotor skills. By contrast, other studies have shown that the use of cannabis in combination with alcohol can greatly influence psychomotor performance, even among more experienced marijuana consumers.

The study’s findings also reaffirmed that elevated THC/blood levels are not necessarily predictive of either increased adverse driving performance or outcomes. Among daily users, mean THC/blood levels were six-times higher than they were for occasional users, despite only nominal differences in the two groups’ driving performance.

Full text of the study, “Simulated driving performance among daily and occasional cannabis users,” appears in Accident Analysis and Prevention.

Oral Cannabis Preparations Associated with Modest Improvements in Patients with Refractory Migraines

Modena, Italy: The long-term use of oral preparations of herbal cannabis is associated with modest improvements in patients with treatment-resistant migraines, according to observational trial data published in the journal Pain Medicine.

A team of Italian investigators assessed the use of herbal cannabis tinctures in a cohort of 32 patients with chronic, refractory migraines. Subjects took one of three varieties of tinctures (high THC/low CBD, high CBD/low THC, nearly equal rations of THC and CBD) daily for a period of six months.

Inconsistent with several other recent studies – such as those here and here – cannabis use was not associated with any reduction in the number of days during which patients experienced migraines. Consistent with other studies, the use of herbal cannabis tinctures reduced patients pain intensity, their need for prescription analgesics, and their use of prescription migraine rescue medications. Cannabinoid tinctures were also associated with reduced incidences of nausea and vomiting.

Authors concluded: “The observed improvements in the NRS [numeric rating scale] score, AC [analgesic consumption], and NDM [number of days on medication] may suggest a role of the oral cannabinoid preparations in patients with CM and a high analgesic consumption. … In order to clearly establish the real magnitude of the effect of oral cannabinoid preparations in the treatment of CM, randomized, placebo-controlled studies with big samples are needed.”

Several prior studies have reported that those suffering from migraines often turn to cannabis for symptomatic relief, and many patients say that it is more effective than prescription medications.

Full text of the study, “Oral cannabinoid preparations for the treatment of chronic migraine: A retrospective study,” appears in Pain Medicine.

Brain Study: Cannabis Use Not Correlated with Changes in White Matter Integrity

Rotterdam, The Netherlands: Subjects with a history of cannabis use, including near-daily consumption, possess no significant differences in white matter integrity when compared to those with no history of marijuana exposure, according to data published in the journal Addiction Biology.

A team of investigators from The Netherlands and from Australia performed MRIs to compare whole-brain white matter microstructure in a cohort of 39 near-daily cannabis users and 28 closely matched controls. The integrity of white matter microstructure is correlated with cognitive performance.

Consistent with prior studies, authors reported: “White matter microstructure did not differ between cannabis users and controls and did not covary with recent cannabis use, dependence severity, or duration of use.”

Investigators concluded, “These findings suggest that long-term near-daily cannabis use does not necessarily affect white matter microstructure.” Nonetheless, they cautioned that adolescents may be susceptible to possible changes in brain morphology.

Full text of the study, “The relation between cannabis use, dependence severity and white matter microstructure: A diffusion tensor imaging study,” appears in Addiction Biology.

Clinical Trial: CBD Dosing Associated with Transient Improvements in Sleep Satisfaction

São Paulo, Brazil: The administration of CBD is associated with temporary improvements in sleep satisfaction in patients with REM sleep behavior disorder (RBD), according to the results of a randomized, placebo-controlled study published in the journal Movement Disorders. Patients diagnosed with RBD experience violent arm and leg movements during REM sleep. These movements are typically associated with vivid nightmares.

Brazilian researchers compared the use of CBD versus placebo in a cohort of 33 patients with RBD and Parkinson’s disease.

Compared to placebo, CBD administration at 300mgs was associated with temporary improvements in subjects’ average sleep satisfaction. However, CBD dosing was not associated with any significant reduction in patients’ RBD frequency.

Several prior studies have reported promising results for the use of either cannabis or cannabinoids to mitigate various sleep-related disorders, including insomnia, sleep apnea, and nightmares.

Full text of the study, “Cannabidiol for rapid eye movement sleep behavior disorder,” appears in Movement Disorders.

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