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Study to trial medical cannabis for spinal injury pain

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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.

 

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Lifestyle

NFL to explore effects of CBD in players with chronic pain

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The NFL-NFLPA Pain Management Committee wants to find alternative treatments to manage player's chronic pain

America’s National Football League (NFL) is looking into how cannabis and CBD can help in managing player’s chronic pain.

The league and player’s association (NFLPA) made a formal request for information to researchers on “pain management alternatives to opioids” earlier this month.

In an official statement, the NFL-NFLPA Pain Management Committee (PMC) said it is working to “improve player health through evidence-based treatment of acute and chronic pain” and to “facilitate research to better understand and improve potential alternative treatments.”

The NFL is seeking out qualified researchers who could lead studies into pain management and athletic performance in its players.

Areas of investigation include the potential therapeutic role of medications and “non-pharmacological interventions” that are considered to be alternatives to opioids in routine pain management of NFL players, including, but not limited to, cannabinoids such as CBD.

The committee also wants to explore the cannabis or cannabinoids on athletic performance in NFL players.

The PMC was formed in 2019 as part of the NFL-NFLPA Collective Bargaining Agreement with the goal of benefitting the health and safety of NFL players through education and research.

Last year it conducted two informational forums on CBD to learn about the current state of CBD science and manufacturing in the US, as part of its aim to find alternatives to opioids in the pain management of players.

Respondents to the request are expected to have experience conducting controlled, experimental studies in the relevant areas and should be affiliated with institutions or companies that meet state, federal, and IRB requirements.

However the NFL is not committing to funding any specific studies at this stage, and instead wants to seek out qualified scientists who can assist with future research projects.

CBD is not currently listed on the World Anti-Doping Agency’s Prohibited List and, as a result, is permitted for use in sport.

However, all other cannabinoids such as cannabis, marijuana and THC are prohibited in competition due to the receptors activated in the brain which cause a ‘high’.

A 2018 review assessed the impact CBD has on relieving chronic pain. The review examined a number of studies, concluding that CBD was effective in overall pain management and didn’t cause any other negative side effects.

In addition, it has been suggested that CBD can speed recovery and fight fatigue – welcome news for athletes suffering from long-term or recurring injuries.

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Health

How can CBD help arthritis?

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In a Canadian study, nine out of 10 patients said CBD was effective in managing their pain

In the UK, more than 10 million people have arthritis or other, similar conditions that affect the joints – and many are turning to CBD products to ease their pain and discomfort.

With an ever-expanding range of drinks, gummies and edibles on thee market CBD could be seen as something aimed at the younger generation.

However, there is a growing body of research that suggests CBD can also be of great use for the older members of the population – and one condition in particular.

Arthritis is a common condition that causes pain and inflammation in a joint, and while it can affect people of all ages, it is more likely to begin when people are in their 40s and 50s, worsening with age.

A Canadian study from 2020 found that up to one in five patients who consulted an orthopedic surgeon for chronic musculoskeletal pain were using a cannabis product to treat them, with the express aim of reducing pain.

The researchers also found that interest in the compound was high, with two thirds of non-users curious to try a cannabis product to treat their muscle and joint pain.

Furthermore, those patients already using CBD had generally positive experiences using the products. Nine out of 10 said it was effective in managing their pain, and four in 10 said it decreased their reliance on other pain medications. Nearly 6 in 10 said cannabis products were more effective than other drugs.

Such findings corroborate what we already know about CBD; thanks to its anti-inflammatory and analgesic properties, early research into its use as a treatment for acute and chronic pain is promising.

A 2016 study found that transdermal cannabidiol has potential for reducing pain and inflammation associated with arthritis without any noticeable side effects.

Cannabis-based medicines can help manage the pain of arthritis by rebalancing the body’s natural endocannabinoid pain-processing system and soothing inflamed body tissues.

There are two primary ways of taking a CBD supplement; topically or orally.

In the case of arthritis, a cream or ointment containing CBD would be rubbed into the affected area. Topical products may also include common over-the-counter ingredients such as menthol, capsaicin or camphor, which could make it difficult to determine if any positive effect is due to the CBD or another ingredient.

There are a number of ways to take CBD orally, from gummies, snacks and drinks to tinctures and capsules – although gummies are discouraged in households with children, due to their similarity with sweets.

However, all work in largely the same way, being absorbed through the digestive tract. However, it is worth noting that absorption can be slow and dosing is tricky due to the delayed onset of effect (one to two hours), unknown effects of stomach acids, recent meals and other factors.

Whichever method you choose, it is always a good idea to check with your medical practitioner first, as CBD, although it is natural, may interact with other treatments, such as prescription medications.

However, for those looking for an alternative to prescribed drugs, with fewer side effects, CBD could well prove to be the answer.

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9 out of 10 readers have self-medicated with cannabis

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Nine out of 10 Cannabis Health readers have consumed cannabis for medical purposes without a prescription – and almost all said they found it to be more effective than conventional medicines.

 

Over the last few weeks, we’ve been asking for your views on social media to delve deeper into how people are consuming cannabis.

As expected, the proportion of our readers who self-medicate with cannabis was high, but the results also demonstrate the perceived effectiveness of cannabis in comparison with traditional medication, highlighting a need for wider access to safe cannabis based medicines.

Self-medicating

Despite the law around medical cannabis changing over two years ago, gaining a prescription can still be challenging, particularly on the NHS.

This has forced a lot of patients to take matters into their own hands.

According to research, as many as 1.4 million Brits are self-medicating with cannabis, equivalent to just over two percent of the country’s population.

Studies from the US have backed this up, with one suggesting that as many as a third of teenagers with a chronic health condition have taken it upon themselves to manage their symptoms with cannabis.

We asked our readers if they were self-medicating to treat a health condition, with the results confirming that almost 94 percent of people said they were.

On top of this, a further five percent said they were not currently, but were open to the idea.

Just over one percent said they weren’t self-medicating due to the stigma attached, however no one responded that the law was a factor in this. 

Effectiveness of self-medicating 

 

Anecdotal evidence and some early studies suggest that cannabis can ease symptoms of some chronic pain conditions, such as fibromyalgia, where other, more conventional medicines have failed.

There is also promise in the potential of cannabis to relieve some mental health conditions, with some saying it has provided huge relief for disorders such as PTSD.

Ninety five percent of Cannabis Health readers polled said they found cannabis extremely effective at relieving symptoms. 

In addition no one said they had found it ineffective when it comes to treating their condition.

The remaining five percent said they found it to have a similar effect as their conventional treatments. 

Route to administration 

How patients consume cannabis can have an impact on its effectiveness, as well as how quickly it kicks in.

With such high numbers both self-medicating and reporting positive effects, we wanted to discover the common consumption methods.

Smoking the flower is the traditional method of consuming cannabis and often viewed as the one which can provide the most relief.

However, even though it has been seen to be less harmful than tobacco, smoking can still lead to a number of other health issues and is note recommended by health professionals.

Despite this, it remained the most popular choice among Cannabis Health readers, with just over a third saying this is how they consume cannabis.

The modern alternative to this is vaping, which was the second most common route to administration among Cannabis Health readers.

Around a third of readers said this was their preferred consumption method.

Some professionals argue this is the healthiest way for consumption, with clinics recommending vaping cannabis flower, but more research is needed in this area.

One method which has few negative effects is the use of oils or tinctures.

This is typically how CBD is consumed, with 21 percent of readers saying this was their preferred method.

Self-medicating alongside conventional medicines

The NHS says it is unlikely that many people in the UK will be able to gain access to a medical cannabis prescription.

Despite this, many patients have chosen to self-medicate with cannabis either alongside or often in the place of conventional therapies. 

The majority of readers agreed with this, with 55 percent saying they no longer use conventional medicines in favour of cannabis.

A further 22 percent said they would only use their conventional medicines if they did not have access to cannabis and the remainder said that they still consume cannabis alongside conventional medication.

Want to get involved? Cannabis Health will be running a number of polls over on our social media pages, to find out more about your views on CBD and cannabis for medical and wellbeing purposes.

Follow @CannabisHnews on Twitter and @Cannabishealthmag on Instagram and keep an eye out.

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