A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis

Barth L. Wilsey, Reena Deutsch, Emil Samara, Thomas D. Marcotte, Allan J. Barnes, Marilyn A. Huestis, Danny Le

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

A randomized, placebo-controlled crossover trial utilizing vaporized cannabis containing placebo and 6.7% and 2.9% delta-9-tetrahydrocannabinol (THC) was performed in 42 subjects with central neuropathic pain related to spinal cord injury and disease. Subjects received two administrations of the study medication in a 4-hour interval. Blood samples for pharmacokinetic evaluation were collected, and pain assessment tests were performed immediately after the second administration and 3 hours later. Pharmacokinetic data, although limited, were consistent with literature reports, namely dose-dependent increase in systemic exposure followed by rapid disappearance of THC. Dose-dependent improvement in pain score was evident across all pain scale elements. Using mixed model regression, an evaluation of the relationship between plasma concentrations of selected cannabinoids and percent change in items from the Neuropathic Pain Scale was conducted. Changes in the concentration of THC and its nonpsychotropic metabolite, 11-nor-9-carboxy-THC, were related to percent change from baseline of several descriptors (eg, itching, burning, and deep pain). However, given the large number of multiple comparisons, false-discovery-rate-adjusted P-values were not significant. Plans for future work are outlined to explore the relationship of plasma concentrations with the analgesic response to different cannabinoids. Such an appraisal of descriptors might contribute to the identification of distinct pathophysiologic mechanisms and, ultimately, the development of mechanism-based treatment approaches for neuropathic pain, a condition that remains difficult to treat.

Original languageEnglish (US)
Pages (from-to)587-598
Number of pages12
JournalJournal of Pain Research
Volume9
DOIs
StatePublished - Aug 31 2016

Fingerprint

Dronabinol
Cannabinoids
Cannabis
Analgesics
Neuralgia
Pain
Pharmacokinetics
Placebos
Spinal Cord Diseases
Pain Measurement
Pruritus
Spinal Cord Injuries
Cross-Over Studies
Therapeutics

Keywords

  • Analgesia
  • Blood concentrations
  • Cannabinoids
  • Medical marijuana

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis. / Wilsey, Barth L.; Deutsch, Reena; Samara, Emil; Marcotte, Thomas D.; Barnes, Allan J.; Huestis, Marilyn A.; Le, Danny.

In: Journal of Pain Research, Vol. 9, 31.08.2016, p. 587-598.

Research output: Contribution to journalArticle

Wilsey, Barth L. ; Deutsch, Reena ; Samara, Emil ; Marcotte, Thomas D. ; Barnes, Allan J. ; Huestis, Marilyn A. ; Le, Danny. / A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis. In: Journal of Pain Research. 2016 ; Vol. 9. pp. 587-598.
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