Medical cannabis improves patients’ quality of life more than any other treatment for chronic pain, says a panel of leading experts.
Medical cannabis is among the most effective treatments for people with long-term, problematic neuropathic pain, according to the new paper.
Researchers used the latest assessment methods to measure the effectiveness of commonly used drugs’ at managing pain and improving patients’ quality of life, against side effects.
Medical cannabis was found to have the best overall benefit-safety balance for patients, with its ability to reduce pain and improve the quality of life for patients with chronic neuropathic pain (CNP).
The paper also finds that it is safer overall than other commonly prescribed medications, and that patients taking cannabis-based medications would be less likely to experience many of the side effects associated with more established treatments.
One in 11 people in the UK suffer from chronic neuropathic pain – including conditions such as nerve damage, sciatica or severe numbing in hands and feet – that substantially impacts on their quality of life.
A panel made up of international clinicians, experts and patients, used a multicriteria decision analysis (MCDA) model to compare the safety of cannabis products to those of the nine drugs that are most commonly prescribed for CNP.
Cannabis-based products containing a 1:1 ratio of THC and CBD, were found to have a higher benefit-safety profile than commonly used medications such as Amitriptyline and Tramadol.
The patient’s perspective
Authors concluded that medical cannabis contributes more to CNP patients’ quality of life and is more favourable in terms of side-effects such as cognitive impairment, dizziness, constipation, affect disorders, overdose toxicity, respiratory depression, withdrawal, and dependency.
Patient representative Abby Hughes, who took part in the study, said the patient contribution was “crucial” in highlighting the importance of quality of life compared to reduction in pain.
“It is crucial patients were able, for the first time in an MCDA setting, to share their lived-experience in a study identifying the benefit-safety balance of neuropathic pain medications. After all, we are the ones experiencing pain and seeking pain relief for a better quality of life,” said Hughes.
“Sharing our experiences equated to the difference in quality of life actually being judged as more clinically important to patients than the difference in pain relief.”
She continued: “Interestingly, with the benefits of 12 neuropathic pain medications mapped out, cannabis takes the lead.
“The safety was also mapped out, identifying adverse and serious adverse events, from constipation to overdose toxicity.
“Cannabis came out as equal or better in safety. Whilst ibuprofen came out as just as safe, it was also least effective, weighted as zero for pain relief and quality of life benefits.”
The report comes just weeks after the International Association for the Study of Pain (IASP) said it could ‘not endorse’ the general use of cannabinoids to treat pain, due to a lack of evidence from ‘high quality research’.
The Faculty of Pain Medicine at the Australian and New Zealand College of Anaesthetists (ANZCA) has also advised against prescribing cannabis for patients with chronic, non-cancer pain unless they are enrolled in a clinical trial.
A co-author of the CNP and cannabinoids study, Professor Mike Barnes, who has been critical of the IASP statement, said these findings go some way to “refute” its conclusions.
“I wish those writing such reports actually spoke to real patients deriving real benefit from cannabinoids for chronic pain,” said Prof Barnes.
“They should try to move beyond the narrow pharmaceutical paradigm, understand the plant and not forget that a doctors’ primary duty is to help their patients.
“This study illustrates the efficacy and safety of cannabis and goes some way to refute the conclusions of the report of the IASP which said there was insufficient evidence to prescribe cannabinoids for pain.”
His co-author, Dr Anne Katrin Schlag, head of research for Drug Science, the UK-based charity which commissioned the paper, told Cannabis Health the team anticipated that the findings would be “controversial”.
“This is another way of broadening the scientific evidence base, rather than solely sticking to randomised control trial (RCT) data,” said Dr Schlag.
“What is very important here is that the study is a comparison between different pain medications, including medical cannabis.
“While medical cannabis was not found to be the best at reducing pain, when taking quality of life into account and patients being able to function, eat and sleep well, then for the average person, cannabinoids tend to work better than the opioids, which tend to have serious side effects.”
Another blow for chronic pain patients
Last week, in another blow for chronic pain patients, the National Institute of Health and Care Excellence (NICE) released new guidance advising UK doctors not to prescribe conventional painkillers including opioids and paracetamol for chronic primary pain.
Instead it is recommended that patients with these conditions are offered a “range of treatments” to manage their pain, including exercise, CBT and acupuncture.
With access to cannabis medicines still restricted in the UK, there has been a backlash from patients who fear being left without any viable options.
Dr Schlag continued: “For patients experiencing severe chronic pain there should be the option of opioid based pain medications.
“Exercise and psychological therapies all have a place and will have lots of benefits for some people, but it is likely there will always be people who need stronger medications.”
She added: “At Drug Science we would like to see cannabis added to the current pharmacotherapy in relation to pain.
“There are thousands of patient reported outcomes from those who are using cannabis and cannabinoid products successfully to treat pain, including from our own forthcoming Project Twenty21 findings which are due to be published shortly.”
Building a convincing case
Project Twenty 21, which launched in November 2019, is Drug Science’s landmark study which aims to widen access to medicinal cannabis, enrolling up to 20,000 patients to build Europe’s largest body of evidence for its safety and efficacy.
Drug Science CEO, David Badcock said he hoped this latest paper would encourage regulatory bodies to consider the growing evidence behind medical cannabis and take steps to improve access for patients.
“Since being made legal in 2018, many patients suffering from neuropathic pain have told us that cannabis based medicinal products are effective in reducing their pain and its negative impacts on their everyday lives,” he commented.
“We are pleased to say that this paper corroborates what many patients have been saying for many years, and helps to build a convincing case for more widespread prescription of medical cannabis on the NHS.”
Hughes, who is able to access a prescription for medical cannabis through Project Twenty21, echoed these sentiments, adding: “It is hoped NICE will consider reevaluating their guidelines on medical cannabis, recognising that for many patients cannabis provides a better quality of life, provides better pain relief, and has a better safety profile than many other neuropathic pain medications currently prescribed.”
You can read the full report here
Fair Trials and Last Prisoner Project seek to launch global cannabis justice project
Fair Trials’ Global CEO Norman L. Reimer to discuss the project at Cannabis Europa Conference in London on June 29.
A new initiative from Fair Trials and the Last Prisoner Project aims to redress the harm caused by cannabis prohibition and to secure relief for those in prison for cannabis-related convictions.
The criminal justice reform NGO, Fair Trials hopes that the industry will support its work in countries across the globe where cannabis laws are being liberalised. Through collaboration with local partners in appropriate jurisdictions, the Fair Trials project will identify people in need of legal assistance, and recruit, train and match volunteer lawyers to take on their cases.
Fair Trials has enlisted the help of the Last Prisoner Project, a coalition of cannabis industry leaders, executives and artists dedicated to bringing restorative justice to the cannabis sector.
More and more jurisdictions are allowing adults to use and distribute medical and recreational cannabis. But after decades of prohibition, countless people remain behind bars or continue to suffer the collateral consequences of a cannabis conviction.
“The injustice of cannabis prohibition has resulted in millions of people worldwide serving time in prison or being saddled with a cannabis conviction, which brings with it a lifetime of harmful consequences, ranging from education and employment opportunities to immigration status and parental rights,” said Fair Trials Global CEO, Norman L Reimer.
“Of course, these harmful effects of prohibition not only impact the individuals charged, but also their families and communities. And those effects have been borne disproportionately by minorities, communities of colour, and the socio-economically disadvantaged. Legalising cannabis alone does not equal justice. Together, we must address the ongoing harms of past prohibition and leave no cannabis prisoner behind.”
The project will be modelled on the US Cannabis Justice Initiative, a collaborative effort between the cannabis industry and volunteer lawyers in the United States. When Norman Reimer was the Executive Director of the National Association of Criminal Defense Lawyers (NACDL), he partnered with the Last Prisoner Project to establish the initiative.
“Key to the success of the initiative has been generous donations from legal cannabis companies and consumers nationwide,” said Last Prisoner Project Co-Founder Steve DeAngelo. “Fair Trials, with its global reach as the world’s criminal justice watchdog, is uniquely positioned to build and house the infrastructure that’s going to be needed.”
Tomorrow (29 June), Norman Reimer will address the Cannabis Europa Conference discussing the project. Mr Reimer will be part of a panel entitled ‘Leave No Cannabis Prisoner Behind,’ and will be joined on that panel by Mary Bailey, Managing Director at the Last Prisoner Project; Dr. Laura Garius, Policy Lead at Release; and Denzel Uba, an individual impacted by criminal cannabis prohibition.
TOWIE star Amy Childs launches CBD range in honour of Jorja Foundation
The product range sees a portion of the proceeds going to the Jorja Foundation.
TOWIE star Amy Childs launched her new CBD range this week, with a star-studded event that shone a spotlight on the story of six-year-old Jorja Emerson.
Amy Childs was joined by former Love Islanders, Amy Hart and Cara Delahoyde-Massey, alongside her co-stars, Frankie Essex, Tom Skinner, Carina Lepore, Saffron Lempriere and Mark Ferris, for a heart-warming event celebrating the launch of her new CBD Infused beauty range, Jorja Botanicals.
The signature collection sees a portion of the proceeds going to the Jorja Foundation, which was set up in honour of six-year-old medical cannabis patient, Jorja Emerson.
The event saw The Only Way Is Essex star Frankie Essex, break down in tears as she heard Jorja’s story. Frankie, who gave birth to twins four weeks ago, wiped her eyes when Robin Emerson, Jorja’s father, showed videos of the life-threatening seizures his daughter was suffering before they discovered medical cannabis.
Love Island star, Amy Hart has since taken to Instagram to spread the word about the latest political campaign that sees Childs and Emerson petitioning to make medical cannabis more widely available on the NHS.
The Jorja Botanicals range was inspired by Jorja, who was diagnosed with a rare chromosome abnormality called 1q43q44 deletion, which has a side effect of life-threatening seizures. Her illness resulted in her being admitted to intensive care on two separate occasions, where Robin was told that she may not make it.
To save his daughter’s life, Emerson knew that he had to dig deep and find a treatment that would not only help Jorja but ultimately go on to help others.
At the time it was still illegal to prescribe cannabis in the UK. Emerson joined the campaign to see medical cannabis legalised in the UK in November 2018, and Jorja’s was among the first children to be legally prescribed medicinal cannabis.
In 2021 he went on to create the Jorja Foundation – a charity set up to help other families and children going through the same battles that Robin had to face.
The Jorja Foundation’s core principles are to fund special needs equipment that is not funded through the health system, fund family counselling, private appointments and tests when a second opinion is needed, as well s cannabis-based treatment for children in the UK and to continue to campaign and educate for wider NHS access in the UK for cannabis-based medications.
Childs commented: “When I saw Robin & Jorja’s story on social media it broke my heart.
“As a mum, I couldn’t imagine the pain of being told to take my child home to say goodbye to them. I love that Robin has fought for Jorja & is now helping other families with the Jorja Foundation.
“I’m so happy that I can help the foundation by being the Creative Director of Jorja Botanicals. We have created some beautiful products for the whole family to enjoy. We will be donating a percentage of the proceeds to the foundation so that we can help as many families as possible. ”
Emerson added: “ This is the fruition of a lot of hard work over many months and I am extremely proud to launch what is the first family brand in this category. In the coming weeks, we will also be launching a ‘parent’ focused cosmetic range in partnership with our creative director Amy Childs and our premium line of tincture oils.”
South Africa launches first trial of cannabis for chronic pain
The study will test whether cannabis can replace opioids in the management of chronic pain.
South Africa’s first cannabis trial has launched after initial results “show promise” for the treatment as a replacement for opioids.
The study will involve 1,000 participants who have been taking opioids for pain management for at least three months and are prepared to switch to cannabis as an alternative.
Biodata is the brainchild of Dr Shiksha Gallow, a cannabis clinician and the principal investigator in the trial which took over 18 months to get official clearance.
Dr Gallow said the trial is set to be ground-breaking as South Africa’s first real-world study of medical cannabis. Researchers predict that it will provide much-needed insight into the link between cannabis genetics and patient outcomes.
Dr Gallow told Cannabiz Africa: “We are currently recruiting patients, and data-capturing all the questionnaires and feedback from the patients for the live Study. It has been fairly slow. However, more options have been introduced, as suggested by the patients in the pilot study.
“The pilot results of the study were very promising, as it showed 98 per cent of the patients have some sort of pain relief from the cannabis.
“We were able to wean these patients off their opioid treatment. In the pilot group of patients below the age of 55, it was shown this group preferred to smoke cannabis and patients older than 55 years preferred oil. The patients who smoked the cannabis had relief almost immediately, while the oil took some time to alleviate their pain.”
“Once we reach the sample size required and all of the relevant data has been collated, the results of the study will be published. We have currently renewed this study for another year, due to the initial slow uptake of research participants.”
Patients can apply to be research participants through the Biodata website.
Labat is expanding its footprint over the next few months with the introduction of CannAfrica kiosks in major shopping malls.
The company believes these will be the “ideal locations for physical sign-up points for the study”.
Labat said the kiosks will also serve as Biodata dispensaries and is engaging with a number of vape stores to do the same, although these would have to be subject to South African Health Products Regulatory Authority’s pharma-ethics requirements.
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