An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain From Spinal Cord Injury and Disease

Barth Wilsey, Thomas D. Marcotte, Reena Deutsch, Holly Zhao, Hannah Prasad, Amy Phan

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Using 8-hour human laboratory experiments, we evaluated the analgesic efficacy of vaporized cannabis in patients with neuropathic pain related to injury or disease of the spinal cord, most of whom were experiencing pain despite traditional treatment. After obtaining baseline data, 42 participants underwent a standardized procedure for inhaling 4 puffs of vaporized cannabis containing either placebo, 2.9%, or 6.7% delta 9-THC on 3 separate occasions. A second dosing occurred 3 hours later; participants chose to inhale 4 to 8 puffs. This flexible dosing was used to attempt to reduce the placebo effect. Using an 11-point numerical pain intensity rating scale as the primary outcome, a mixed effects linear regression model showed a significant analgesic response for vaporized cannabis. When subjective and psychoactive side effects (eg, good drug effect, feeling high, etc) were added as covariates to the model, the reduction in pain intensity remained significant above and beyond any effect of these measures (all P < .0004). Psychoactive and subjective effects were dose-dependent. Measurement of neuropsychological performance proved challenging because of various disabilities in the population studied. Because the 2 active doses did not significantly differ from each other in terms of analgesic potency, the lower dose appears to offer the best risk-benefit ratio in patients with neuropathic pain associated with injury or disease of the spinal cord. Perspective A crossover, randomized, placebo-controlled human laboratory experiment involving administration of vaporized cannabis was performed in patients with neuropathic pain related to spinal cord injury and disease. This study supports consideration of future research that would include longer duration studies over weeks to months to evaluate the efficacy of medicinal cannabis in patients with central neuropathic pain.

Original languageEnglish (US)
Pages (from-to)982-1000
Number of pages19
JournalJournal of Pain
Volume17
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Spinal Cord Diseases
Neuralgia
Cannabis
Spinal Cord Injuries
Analgesics
Pain
Linear Models
Wounds and Injuries
Medical Marijuana
Placebos
Placebo Effect
Dronabinol
Therapeutics
Inhalation
Emotions
Odds Ratio
Pharmaceutical Preparations
Population

Keywords

  • analgesia
  • cannabis
  • clinical trial
  • Neuropathic pain
  • neuropsychological testing

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain From Spinal Cord Injury and Disease. / Wilsey, Barth; Marcotte, Thomas D.; Deutsch, Reena; Zhao, Holly; Prasad, Hannah; Phan, Amy.

In: Journal of Pain, Vol. 17, No. 9, 01.09.2016, p. 982-1000.

Research output: Contribution to journalArticle

Wilsey, Barth ; Marcotte, Thomas D. ; Deutsch, Reena ; Zhao, Holly ; Prasad, Hannah ; Phan, Amy. / An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain From Spinal Cord Injury and Disease. In: Journal of Pain. 2016 ; Vol. 17, No. 9. pp. 982-1000.
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