Helen Weston has lived with continuous chronic pain for 37 years, which affects her ability to do everyday things. When she ran out of cannabis during lockdown, she realised it was the one thing keeping her going.
“If it wasn’t for cannabis there is no way I would still be here,” says 54-year-old Helen Weston, who has lived with chronic pain for most of her life.
“I can’t move without it. I’m bed ridden, with no life, all there is is pain. Cannabis is what helps me cope. It’s the only thing that keeps me going and enables me to get through another day.”
Since the age of 16, Helen has suffered from spine and neck problems, which cause her chronic pain and muscle seizures, affecting her ability to move.
Later in life she began experiencing severe migraines brought on by triggers such as stress, flashing lights and computer screens and has a diagnosis of trigeminal neuralgia, described as sudden, severe facial pain which comes on in unpredictable attacks.
Helen realised early on, while still in her teens, that cannabis was more effective at managing her pain than prescription drugs.
“Since I was 16 I have found that the only thing that actually helps is cannabis,” she says.
“I’ve tried all different kinds of painkillers and muscle relaxants, you name it I have tried it, and none of them were very effective, but had a lot of side effects.”
But the fact that cannabis was masking her symptoms so well, meant her broken spine went undiagnosed for almost a decade, after a spinal fusion failed.
“I was ignored for eight years by doctors after my first spinal fusion broke through no fault of my own,” says Helen.
“The stigma attached to cannabis – that I did mention using at the time – and the fact that it masked the symptoms to an extent and gave me so much mobility, despite a broken spine, meant that nobody believed me.
“By the time I got help in 1998 for my second fusion the surgeon said if I had got there sooner, he could have done more.”
Struggling with stigma
Helen has struggled to access cannabis illicitly for most of her life to manage the continuous pain, battling with both the practical and societal constraints.
Helen has struggled to access cannabis illicitly for most of her life, battling with both the practical and societal constraints.
“I’ve lived with continuous chronic pain for more than 30 years, it’s been a real struggle,” she admits.
“The only thing I could do for my back is swim, if I stop swimming my pain levels get higher and my mobility will get lower, so I just kept swimming but I couldn’t swim without the cannabis, I couldn’t move.
Helen continues: “I’ve even tried growing it on a few occasions, but I just couldn’t manage as I wasn’t physically fit enough.
“I’ve always been an advocate, but it’s got me into trouble. I’ve been treated like a fake, and a lazy pothead. When you get chatting to people at swimming, as soon as you say you use cannabis they don’t want to speak to you again.”
Helen adds: “I’ve had very negative responses from the medical profession, but it’s the cannabis that is keeping me alive.
When her cannabis supply ran out during the coronavirus lockdown last year, Helen got a glimpse at what life would be like without it.
“It was unbearable,” she says.
“I was experiencing severe headaches and the pain was immense. I knew it was legal at the time, but my headaches meant I couldn’t do the research on the internet.
“Everything in my body said just end it. If it wasn’t for my counsellor talking me down from one week to the next on the phone, and my friend who went out on a limb, I would have given up. If I run out of cannabis my life stops.”
Helen managed to get hold of a small amount of cannabis through a friend’s neighbour after approaching her and admitting she was “desperate”. It kept her going until she was able to make an appointment with a clinic in the UK.
She now has access to a legal prescription through Integro Medical Clinics, the impact of which has been life changing, she says.
“It really has had a positive effect on my life to get cannabis legally, it’s changed everything,” says Helen.
“I feel safer and more confident speaking about it with medical professionals, I’m not pushed around so much mentally now by it.”
She adds: “When I get it delivered by courier from the cannabis clinic, I still can’t believe it. After all these years I get it delivered legally via courier in a prescription bag, I still have to kick myself.”
Helen now uses a combination of strains, which work for her in different ways, such as helping her movement and motivation so she is able to keep up her swimming, and managing her headaches.
A big part of her life is swimming, which helps to lower her pain levels and improve her mobility, but without cannabis she struggles to
“Although it doesn’t cure it, I’m getting less headaches and they tend to be more mild,” she explains.
“I can use the computer for longer and it takes less time to recover – only a few hours rather than a day or two, so I can respond to an email or do some shopping.”
Something as simple as being able to use the computer for longer has made a huge difference to Helen’s quality of life, allowing her to connect with others in the cannabis and chronic illness communities online and become less isolated.
“My whole life has been about cannabis and I have finally found all these other people that are just like me and they can speak about it openly now,” she says.
“It’s the first time in my life I’ve got other people I can relate to.”
And now that she is comfortable speaking about her experience she is keen to help others access cannabis too.
“I feel really positive about the future, I’m so glad I found the clinic, I just wish it had happened sooner,” she adds.
“I’m not the only one and unfortunately there’s lots of people out there living with chronic pain and disability who probably don’t even know it’s legal, who could be helped by cannabis.”
Largest ever cannabinoid trial on pain finds significant improvement
All formulations in the trial led to “clinically meaningful” improvements in pain after just 4 weeks.
Results have been released from what is claimed to be the largest ever randomised blinded clinical trial on cannabinoids and pain.
Results from a large-sale cannabinoid trial demonstrated “clinically meaningful” improvements in pain across the different formulations of CBD and rare cannabinoids studied.
Claimed to be history’s largest clinical trial on cannabinoids and pain, Radicle Science – an AI-driven healthtech firm – worked in partnership with cannabinoid manufacturer and distributor Open Book Extracts (OBX) to complete the study.
Involving more than 1600 participants from across the US, the companies said the study is the first of its kind to examine the synergistic impact of rare cannabinoids like Cannabichromene (CBC) and Cannabigerol (CBG) on pain.
All of the enhanced product formulations included in this clinical trial led to statistically significant improvements in pain, anxiety, sleep quality and overall quality of life. On average, nearly half (44.8 per cent) of participants who received any of the enhanced products experienced a clinically meaningful improvement in their pain, meaning they realised a distinct and palpable improvement in their quality of life through improved pain symptoms.
The trial was specifically designed to examine if adding other ingredients to a formulation in conjunction with CBD could lead to better outcomes than with CBD alone. The trial included 6 product arms, which all contained CBD at 40 mg per serving. Most arms also contained varying levels of rare cannabinoids, including CBG and CBC.
Overall, the formulations performed roughly the same for the improvement of pain, anxiety, sleep quality and quality of life. However, for people with moderate pain, there was evidence that the addition of 20mg CBC to a formulation containing 40mg of CBD could significantly improve its pain-relieving effects—particularly when this enhanced product was taken for two or more weeks.
“It’s a privilege to make history with OBX,” said Dr Jeff Chen, Radicle Science’s CEO and UCLA Cannabis Research Initiative’s founder. “Rare cannabinoids are present in a variety of health and wellness products containing cannabis and hemp, but there has been virtually no clinical data on their effectiveness for any medical condition, including pain.
“Radicle Science assessed for the first time in history the potential synergistic effects of certain rare cannabinoids on pain and demonstrated that these natural products can make a measurable positive impact.”
A diverse sample of 1629 pain sufferers from across the US were randomised to take one of the six product formulations for a month while reporting their pain relative to specific benchmarks that included severity, general activity, sleep quality, anxiety symptoms and overall quality of life.
All products tested were deemed safe to consume and only about 1 in 10 participants reported side effects, none of which were deemed severe.
“While existing studies suggest that cannabidiol and rare cannabinoids, including CBG and CBC, have considerable potential to support wellness, there has been a glaring gap in scientifically valid research dedicated to guiding effective product development,” said OBX CEO Dave Neundorfer.
“That’s why we collaborated with the renowned medical experts and data scientists at Radicle Science to better understand the potential of rare cannabinoids as an ingredient and, in particular, their ability to support better quality of life outcomes relating to pain.”
Radicle Science and OBX said they will continue their partnership with similar large-scale randomised controlled clinical trials on rare cannabinoids, including THCV, CBN, CBG and CBC. Radicle will be studying their effects on other health and lifestyle benchmarks, such as energy, focus, appetite, sleep disturbance, stress and anxiety, across thousands of study participants.
Pelin Thorogood, Radicle Science Co-founder and Executive Chair added: “It was promising to see that the addition of a rare cannabinoid could augment the effects of CBD.
“We will be further exploring the entourage effect with an upcoming study, Radicle Spectrum, which will be the first head-to-head study comparing full or broad-spectrum CBD to isolate and placebo. It is our hope this study will provide data to help the FDA ascertain whether CBD isolate is a drug.”
Project Twenty21 publishes first findings on chronic pain
Data from over 900 medical cannabis patients, living with chronic pain, has been published this week.
The first condition-specific findings from the UK observational study, Project Twenty21, have been published on chronic pain.
Data from over 900 chronic pain patients, enrolled on Drug Science’s Project Twenty21 (T21), has been published in the leading academic journal, Frontiers, this week.
The first of two papers, explores how cannabis-based medicines can be used in the treatment of chronic pain, and gives an overview of the current patient demographic, as well as highlighting the key challenges facing those living with persistent pain.
Project Twenty21 was launched by UK drug reform charity, Drug Science, in 2019 with the aim of building a database for the safety and efficacy of medical cannabis.
There are currently over 2,600 patients enrolled in the study, of which over 50 per cent are prescribed cannabis for chronic pain.
Who are pain patients in the UK?
According to this new paper, of the 949 people reporting chronic pain as a primary condition, just over half were male, with an average age of 42-years-old.
A range of cannabinoid products were prescribed to this group, with just under half being classified as high-THC flower.
In addition, 92 per cent of those with a primary condition of chronic pain reported experiencing at least one co-morbid secondary condition, with over a third reporting up to six.
These include psychiatric conditions including anxiety and depression, which can also be treated with medical cannabis products. The majority of patients also reported using at least one other prescribed medication (69 per cent).
According to lead author and head of research at Drug Science, Dr Anne Katrin Schlag, one of the key findings of the paper was the low quality of life among pain patients, compared to the general population.
Over half of the sample reported that they experience “severe or extreme problems due to pain”.
“The majority of patients have many co-morbid conditions and because of that suffer with a low quality of life,” Dr Schlag told Cannabis Health.
“The pain interference and pain intensity for the majority of these patients is very high. A lot of them are unable to live their life in the way they would like to do, because the pain is so dominant.
“The low quality of life of the patient was quite astounding in terms of the extent of their problems, in relation to mobility and being able to conduct their usual activities, self-care, as well as issues of anxiety and depression.”
This is significant, the paper says, as the low quality of life of patients, their high number of co-morbidities and wide age range shows that the “myth of medical cannabis patients as young, recreational users looking for a legal source of cannabis can be firmly dispelled”.
A further paper, due to be published later this year, will explore the effects of medical cannabis at a three and six month follow up appointment, including whether the treatment has enabled patients to reduce other prescription medicines, including opioids.
The researchers hope that these findings, which are already showing “promise” will go some way to encouraging regulators to consider real-world evidence.
“This is a huge patient group, chronic pain is a very prevalent condition in the population and NICE does not currently recommend the prescription of cannabis-based medicinal products for chronic pain,” said Dr Schlag.
“We wanted to show that there are lots of people using it already and it would most likely be very beneficial for them to get access through the NHS, as a lot of them need this for chronic conditions for longer periods of time.”
She continued: “If we can show in a follow up paper that cannabis medications have improved pain intensity and the amount that pain interferes in their life, as well as that opioid and other medication use declined, we hope this would influence regulators, including NICE, to perhaps reconsider their recommendations.”
Elsewhere in the world
The initial findings are said to be in line with other real-world data from elsewhere in the world, such as Canada and America.
Similar databases from countries such as Canada, Germany, and Denmark, also include thousands of patients, presenting “convincing findings” according to Dr Schlag.
“There’s so much already out there and findings tend to follow a pattern, especially in terms of pain patients and how beneficial medical cannabis can be to treat chronic pain,” she said.
“We’re hoping that this large-scale database will have an impact on regulators. Especially when you consider that there are more patients combined within all these databases than within all the randomised control trials in this area put together.”
Real-world evidence vs RCTs
Bodies such as NICE, which have called for more robust evidence on the use of medical cannabis in chronic pain, consider randomised control trials (RCTs) to be the “gold standard” of science, despite how restrictive they can be.
“RCTs take place in a very restrictive environment, over a short period of time, with a very small subsample of patients, and are usually not able to involve patients with the number of co-morbidities that we have in this study, ” explained Dr Schlag.
“When we are able to analyse the data over three months, six months, one year – hopefully we will be able to see the benefits, as well as any potential risks, which may or may not occur, and which may not be shown in a short-lived RCT.”
She added: “This is going to be extremely helpful for regulators and prescribers, and we’re very keen for T21 as well as other real world evidence, to be able to contribute to the scientific evidence-base on cannabis medicine.”
Medical cannabis reduces pain and opioid use in cancer patients – study
Findings suggest that medicinal cannabis can be carefully considered as an alternative to the pain relief medicines.
Medical cannabis reduces cancer-related pain and the need for opiate-based painkillers, reveals a new study in oncology patients.
A comprehensive assessment of the benefits of medical cannabis for cancer-related pain, has found that for most oncology patients, pain measures improved significantly, other cancer-related symptoms also decreased, the consumption of painkillers was reduced, and the side effects were minimal.
Published in Frontiers in Pain Research, these findings suggest that medicinal cannabis can be carefully considered as an alternative to the pain relief medicines that are usually prescribed to cancer patients.
Pain, along with depression, anxiety, and insomnia, are some of the most fundamental causes of oncology patient’s disability and suffering while undergoing treatment therapies, and may even lead to worsened prognosis.
Author, David Meiri, assistant professor at the Technion Israel Institute of Technology, explained: “Traditionally, cancer-related pain is mainly treated by opioid analgesics, but most oncologists perceive opioid treatment as hazardous, so alternative therapies are required.
“Our study is the first to assess the possible benefits of medical cannabis for cancer-related pain in oncology patients; gathering information from the start of treatment, and with repeated follow-ups for an extended period of time, to get a thorough analysis of its effectiveness.”
Need for alternative treatment
After talking to several cancer patients, who were looking for alternative options for pain and symptom relief, the researchers were keen to thoroughly test the potential benefits of medicinal cannabis.
“We encountered numerous cancer patients who asked us whether medical cannabis treatment can benefit their health,” said co-author Gil Bar-Sela, associate professor at the Ha’Emek Medical Center Afula.
“Our initial review of existing research revealed that actually not much was known regarding its effectiveness, particularly for the treatment of cancer-related pain, and of what was known, most findings were inconclusive.”
The researchers recruited certified oncologists who were able to issue a medical cannabis license to their cancer patients. These oncologists referred interested patients to the study and reported on their disease characteristics.
Bar-Sela said: “Patients completed anonymous questionnaires before starting treatment, and again at several time points during the following six months. We gathered data on a number of factors, including pain measures, analgesics consumption, cancer symptom burden, sexual problems, and side effects.”
An analysis of the data revealed that many of the outcome measures improved, with less pain and cancer symptoms. Importantly, the use of opioid and other pain analgesics decreased.
In fact, almost half of the patients studied stopped all analgesic medications following six months of medicinal cannabis treatment.
“Medical cannabis has been suggested as a possible remedy for appetite loss, however, most patients in this study still lost weight. As a substantial portion were diagnosed with progressive cancer, a weight decline is expected with disease progression,” reported Meiri.
He continued: “Interestingly, we found that sexual function improved for most men but worsened for most women.”
Meiri would like future studies to dig deeper and look at the effectiveness of medicinal cannabis in different groups of cancer patients.
“Although our study was very comprehensive and presented additional perspectives on medical cannabis, the sex, age, and ethnicity, as well as cancer types and the stage of the cancer meant the variety of patients in our study was wide-ranging. Therefore, future studies should investigate the level of effectiveness of medicinal cannabis in specific subgroups of cancer patients with more shared characteristics.”
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