Pain research

Cannabinoids are as effective against pain as some approved medications (Martín-Sánchez et al., 2009). They are particularly suited for the treatment of chronic pain resulting from nerve damage (Rahn & Hohmann, 2009). There are often no other effective treatments or medications for these patients.

The therapeutic application of cannabinoids in the treatment of certain chronic pains is well-documented nowadays and, in many cases, it is an appropriate and indispensable option. As an additional therapy option, especially in the case of chronic pain such as tumour-related pain, HIV-related nerve pains or spasticity in the case of muscular sclerosis, cannabinoids provide an outstanding service and largely one with few side effects. In recent years, increasing numbers of high-quality, randomised, controlled, clinical scientific investigations have been conducted on the use of cannabinoids for the treatment of pain.

For example, a Canadian study from 2011 shows that the synthetic cannabinoid Nabilone has proven itself to be an effective and well-tolerated complementary therapy to Gabapentin for MS patients with neuropathic pain. A very broad spectrum of efficacy has meanwhile been established: THC is also effective on certain neuropathies following an HIV infection, multiple sclerosis, transverse spinal cord syndrome or other pains resulting from spasticity. Furthermore, there are promising indications on the potential of this remedy in the treatment of various chronic inflammatory diseases, such as rheumatoid arthritis or chronic inflammatory bowel diseases. A particularly synergetic combination is that of THC with a classic opioid therapy. In contrast to opioids, cannabinoids do not lead to a potentially life-threatening respiratory depression in the event of overdosage, nor to suppression of important immune functions against infectious germs.

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Chronic pain

Cannabinoids are especially effective against (chronic) neuropathic pain and pain associated with MS, whereas they are weak or ineffective in the case of acute pain. In a parallel group study of smoked cannabis featuring 50 patients with HIV-associated neuropathic pain, cannabis reduced the pain by an average of 34 % (versus 17 % under placebo). In the cannabis group, 52% experienced a pain reduction > 30 % (24 % in the placebo group).

In a controlled crossover study (n = 24) Dronabinol (up to 10 mg/day) reduced MS-related pain by 3 points (scale from 0–10) on average, compared with 0 points under placebo. None of the controlled studies indicated that cannabinoids are also effective against chronic pain resulting from other causes (tumour-related pain, rheumatism, fibromyalgia).

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