Study to trial medical cannabis for spinal injury pain

The Lambert Initiative has won funding to trial cannabidiol for treating chronic pain caused by spinal injury.

Researchers at the University of Sydney have been awarded US$1.7 million to research the chronic pain that commonly occurs after spinal cord injury.

The project aims to use advanced brain imaging techniques to identify and understand the specific changes that are occurring in the brain after spinal trauma that lead to the development of chronic neuropathic pain.

The research team expects that understanding the underlying changes in the brain will help identify or develop targeted and effective treatment options for this condition.

One treatment option holding therapeutic potential is medicinal cannabis.

“Unfortunately, half of all patients who suffer a spinal cord injury will develop chronic pain. This chronic neuropathic pain is often so severe that many regard it as the most debilitating consequence of their injury,” said the study’s lead investigator Professor Luke Henderson in the School of Medical Sciences.

“Treatment options have proven ineffective and often introduce significant side effects that further exacerbate the condition.”

Professor Henderson, an expert in human brain imaging and pain has teamed up with cannabinoid, neuroinflammation and spinal injury experts to test the hypothesis that cannabidiol (CBD), one of the main and non-intoxicating compounds found in cannabis, could be an effective treatment option.

Researchers will test to see if cannabidiol can reduce the specific type of neuropathic pain that develops in spinal cord injury patients.

The project has received $1.45 million from NSW Health and $350,000 from the University.

The research team includes Professor Iain McGregor, the academic director of the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney, Dr Elizabeth Cairns, a research fellow also from the Lambert Initiative, and Dr Sachin Shetty, a clinician at Prince of Wales hospital who works with spinal injury patients.

Cannabidiol is already being used by some patients who gain special access through the Therapeutic Goods Administration and they are reporting positive results.

According to Spinal Cord Injuries Australia, medicinal cannabis can help patients as it “shuts down the sensation of pain. In other people, it helps them to disassociate and relax so that they’re not so aware of the pain, enabling them to get on with their day.”

However, these reports are based on anecdotal evidence.

This newly funded study will rigorously assess cannabidiol’s efficacy at treating chronic pain after spinal cord injury.

Professor Henderson said: “We will be able to explore for the first time, the effects of CBD on brain function in chronic pain and our ability to determine the relationship between changes in pain and brain structure and function associated with CBD.”

The team of researchers plan to conduct a clinical trial that will give cannabidiol to patients with spinal cord injury-induced chronic pain to determine if it can reduce their pain. The first part of the study will compare brain images of individuals who develop chronic pain after spinal cord injury to those who do not. This will help determine underlying brain changes responsible for the chronic neuropathic pain.

In the second part of the study, a randomised, double-blind placebo-controlled study will be used to investigate cannabidiol’s ability to reduce pain.

“While there are some studies showing that CBD can reduce pain in other chronic conditions, no one fully understands how it works to reduce pain. Our study can help tease this out,” Professor Henderson said.

The research team welcomed the funding from the NSW government and its recognition and support for the potential of cannabinoid therapeutics.

“The Lambert Initiative is committed to working in areas of unmet need and severe suffering. Supporting spinal injury patients with cannabis-based medicines provides an opportunity to do exactly that,” Professor McGregor said.

Dr Cairns added: “We hope this research will be able to make real impacts for patients and their families, paving a path towards an effective treatment for a greater number of patients.”

The NSW government funding is part of a $15 million scheme supporting seven research projects to improve the health of people with spinal cord injuries. It will be conducted at the Prince of Wales Hospital, NeuRA and the University of Sydney; taking place over four years with the first trials expected to begin in the first half of 2021.