• En En
    • Fr Fr
  • Medical Cannabis and Neuropathic Pain

    Medical Cannabis and Neuropathic Pain

    Did you know that the most common reason patients use medical cannabis is to treat pain?1 

    Based on a review of the pain and cannabis literature conducted by the National Academies of Science, Engineering, and Medicine, cannabis appears to be an effective treatment for chronic pain2. In particular, cannabis appears to be beneficial for the treatment of neuropathic pain2. But what exactly is chronic neuropathic pain? Let’s take a closer look.  

    What is Chronic Neuropathic Pain? 

    Chronic neuropathic pain is the result of nerve damage3. It can be mediated by central causes (e.g., stroke, multiple sclerosis) and by peripheral causes (e.g., diabetic neuropathy, surgical procedures)4. 

    Neuropathic pain has a high personal and economic burden in Canada5–7. It has shown to interfere with daily activities, work, and performance of household activities/volunteer work7. 

    Some of the strongest evidence for cannabis and neuropathic pain is from studies examining their efficacy in human immunodeficiency virus (HIV), diabetic neuropathy, and multiple sclerosis (MS) pain8–12. Let’s examine how medical cannabis may be helpful in treating these conditions. 

    Diabetic Neuropathy 

    Diabetes affects approximately 422 million people around the world13. Diabetic neuropathy is diagnosed in approximately 10% of diabetic patients14. This type of nerve damage typically leads to diabetic patients complaining of pain and hyperalgesia in their feet15, which causes great distress and disability among those affected and decreases quality of life15. Less than a third of patients suffering from diabetic neuropathy achieve at least a 30% reduction in pain intensity17, suggesting a need for additional treatments. 

    Studies on cannabinoid use show some promise in pain management in diabetic neuropathy. Toth et al. examined the effect of a synthetic THC cannabinoid as an adjunct treatment for painful refractory diabetic neuropathy in a placebo controlled, randomized withdrawal study18. The treatment was associated with improvements in pain, anxiety, well-being, and sleep disturbances18. 

    Wallace et al. studied the efficacy of inhaled cannabis in patients with painful diabetic peripheral neuropathy19. Participants were exposed to placebo or THC (1%, 4%, and 7%), with results showing a dose-dependent reduction in pain intensity in response to inhaled cannabis in patients19. 

    Human Immunodeficiency Virus (HIV) 

    One complication of HIV infection is the accompanying pain, which has effects on quality of life24. 

    Chayama et al. conducted in-depth interviews with 25 people living with HIV20. Of those individuals reporting pain, smoking cannabis was a preferred method of consumption, due to its rapid onset20. Participants also preferred indica or high THC products20. This study found a reduction in pain levels after cannabis use, with the majority reporting a reduction of 2-3 points on a pain scale with a range of 0 (no pain) to 10 (most severe pain)20. Cannabis use also led to improved daily functioning, and most participants reported using less prescription or illicit drugs (e.g., benzodiazepines, opioids) to manage pain and related symptoms20. 

    Multiple Sclerosis (MS) Pain 

    Scientific data has shown that 60% of individuals with MS will experience MS-related pain, which includes neuropathic and musculoskeletal pain21. 

    An analysis of several studies of cannabis-based treatments for neuropathic and MS-related pain included seven articles with a total of 298 patients22. Based on pooled data, pain scores decreased by 1.6 ± 0.4 points (on a 11-point scale) and cannabinoids were significantly superior to placebo by 0.8 ± 0.3 points22. The meta-analysis concluded that cannabinoids are effective in treating neuropathic pain in MS22. 

    Several other studies have evaluated the effect of neuropathic pain in people diagnosed with MS23. A small clinical trial involving 15 people diagnosed with chronic MS found that cannabis combined with gabapentin (an oral pain medication) was effective and well tolerated for treating neuropathic pain23.

    Have Questions About Medical Cannabis? 

    If you have questions about medical cannabis, reach out to your healthcare practitioner. They are best suited to help you understand how cannabis may support your health.  

    If you still have any questions or want to learn more, you can call our Client Care team at 1-877-9AURORA MEDICAL (1-877-928-7672) or email askus@auroramedical.com. If you are looking to get a prescription, you can book an online appointment with our clinic partner, Canadian Cannabis Clinics. 

     

     

     

     

    REFERENCES 

    1. Kosiba JD, Maisto SA, Ditre JW. Patient-reported use of medical cannabis for pain, anxiety, and depression symptoms: Systematic review and meta-analysis. Social Science & Medicine. 2019;233:181-192. doi:10.1016/J.SOCSCIMED.2019.06.005 
    2. National Academies of Sciences E and M. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Psychiatria. 2017;15(2):88-92. doi:10.17226/24625 
    3. Pantoja-Ruiz C, Restrepo-Jimenez P, Castañeda-Cardona C, Ferreirós A, Rosselli D. Cannabis and pain: a scoping review. Brazilian Journal of Anesthesiology (English Edition). Published online July 16, 2021. doi:10.1016/J.BJANE.2021.06.018 
    4. Treede R-D, Rief W, Barke A, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003. doi:10.1097/ J.PAIN.0000000000000160 
    5. Berger, A., Dukes, E. M., & Oster, G. (2004). Clinical characteristics and economic costs of patients with painful neuropathic disorders. The Journal of Pain, 5(3), 143-149. 
    6. Lachaine J, Gordon A, Choinière M, Collet J, Dion D, Tarride J-E. Painful neuropathic disorders: An analysis of the Régie de l’Assurance Maladie du Québec database. Pain Research & Management : The Journal of the Canadian Pain Society. 2007;12(1):31. doi:10.1155/2007/713835 
    7. Tarride JE, Collet JP, Choinière M, Rousseau C, Gordon & A. The economic burden of neuropathic pain in Canada. Published online 2006. doi:10.3111/200609055068 
    8. Meng H, Hanlon JG, Katznelson R, Ghanekar A, McGilvray I, Clarke H. The prescription of medical cannabis by a transitional pain service to wean a patient with complex pain from opioid use following liver transplantation: a case report. Canadian Journal of Anesthesia/ Journal canadien d’anesthésie. 2016;63(3):307-310. doi:10.1007/s12630-015-0525-6 
    9. Toth C, Mawani S, Brady S, et al. An enriched-enrolment, randomized withdrawal, flexible-dose, double-blind, placebo-controlled, parallel assignment efficacy study of nabilone as adjuvant in the treatment of diabetic peripheral neuropathic pain. Pain. 2012;153(10):2073-2082. doi:10.1016/j.pain.2012.06.024 
    10. Svendsen KB, Jensen TS, Bach FW. Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? Randomised double blind placebo controlled crossover trial. BMJ. 2004;329(7460):253. doi:10.1136/bmj.38149.566979.AE 
    11. Rog DJ, Nurmikko TJ, Friede T, Young CA. Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology. 2005;65(6):812-819. doi:10.1212/01.wnl.0000176753.45410.8b 
    12. Lynch ME, Ware MA. Cannabinoids for the Treatment of Chronic Non-Cancer Pain: An Updated Systematic Review of Randomized Controlled Trials. Journal of Neuroimmune Pharmacology. 2015;10(2):293-301. doi:10.1007/s11481-015-9600-6 
    13. World Health Organization. Diabetes. Accessed October 12, 2021. https://www.who.int/news-room/fact-sheets/detail/diabetes 
    14. Low PA, Dotson RM. Symptomatic Treatment of Painful Neuropathy. JAMA. 1998;280(21):1863-1864. doi:10.1001/JAMA.280.21.1863 
    15. Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Research and Clinical Practice. 2000;47(2):123-128. doi:10.1016/S0168-8227(99)00112-6 
    16. Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Research and Clinical Practice. 2000;47(2):123-128. doi:10.1016/S0168-8227(99)00112-6 
    17. Snedecor SJ, Sudharshan L, Cappelleri JC, Sadosky A, Mehta S, Botteman M. Systematic Review and Meta-Analysis of Pharmacological Therapies for Painful Diabetic Peripheral Neuropathy. Pain Practice. 2014;14(2):167-184. doi:10.1111/papr.12054 
    18. Toth C, Mawani S, Brady S, et al. An enriched-enrolment, randomized withdrawal, flexible-dose, double-blind, placebo-controlled, parallel assignment efficacy study of nabilone as adjuvant in the treatment of diabetic peripheral neuropathic pain. Pain. 2012;153(10):2073-2082. doi:10.1016/j.pain.2012.06.024 
    19. Wallace MS, Marcotte TD, Umlauf A, Gouaux B, Atkinson JH. Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. The journal of pain : official journal of the American Pain Society. 2015;16(7):616. doi:10.1016/J.JPAIN.2015.03.008
    20. Chayama KL, Valleriani J, Ng C, et al. The role of cannabis in pain management among people living with HIV who use drugs: A qualitative study. Drug and Alcohol Review. Published online 2021. doi:10.1111/dar.13294 
    21. Foley PL, Vesterinen HM, Laird BJ, et al. Prevalence and natural history of pain in adults with multiple sclerosis: Systematic review and meta-analysis. Pain. 2013;154(5):632-642. doi:10.1016/j.pain.2012.12.002 
    22. Iskedjian M, Bereza B, Gordon A, Piwko C, Einarson T. Meta-analysis of cannabis based treatments for neuropathic and multiple sclerosis-related pain. Current Medical Research and Opinion. 2007;23(1):17-24. Accessed August 29, 2021. https://www.ncbi.nlm.nih.gov/ books/NBK74699/ 
    23. Turcotte D, Doupe M, Torabi M, et al. Nabilone as an Adjunctive to Gabapentin for Multiple Sclerosis-Induced Neuropathic Pain: A Randomized Controlled Trial. Pain Medicine. 2015;16(1):149-159. doi:10.1111/pme.12569 
    24. Pardo CA, McArthur JC, Griffin JW. HIV neuropathy: Insights in the pathology of HIV peripheral nerve disease. Journal of the Peripheral Nervous System. 2001;6(1):21-27. doi:10.1046/j.1529-8027.2001.006001021.x 
    Previous Article Next Article

    You must be of legal age in your province of residence to view our content.

    Go Back

    • En En
    • Fr Fr
    • Better Together
    Welcome to Aurora. A family of medical cannabis brands.

    Patient Login

    Forgot password?

    This website uses cookies to enable essential features, please review our Cookie Policy for more information on how to manage and personalize your experience.