Low-dose vaporized cannabis significantly improves neuropathic pain

Barth Wilsey, Thomas Marcotte, Reena Deutsch, Ben Gouaux, Staci Sakai, Haylee Donaghe

Research output: Contribution to journalArticle

147 Scopus citations

Abstract

We conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Thirty-nine patients with central and peripheral neuropathic pain underwent a standardized procedure for inhaling medium-dose (3.53%), low-dose (1.29%), or placebo cannabis with the primary outcome being visual analog scale pain intensity. Psychoactive side effects and neuropsychological performance were also evaluated. Mixed-effects regression models demonstrated an analgesic response to vaporized cannabis. There was no significant difference between the 2 active dose groups' results (P >.7). The number needed to treat (NNT) to achieve 30% pain reduction was 3.2 for placebo versus low-dose, 2.9 for placebo versus medium-dose, and 25 for medium- versus low-dose. As these NNTs are comparable to those of traditional neuropathic pain medications, cannabis has analgesic efficacy with the low dose being as effective a pain reliever as the medium dose. Psychoactive effects were minimal and well tolerated, and neuropsychological effects were of limited duration and readily reversible within 1 to 2 hours. Vaporized cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain. Perspective: The analgesia obtained from a low dose of delta-9- tetrahydrocannabinol (1.29%) in patients, most of whom were experiencing neuropathic pain despite conventional treatments, is a clinically significant outcome. In general, the effect sizes on cognitive testing were consistent with this minimal dose. As a result, one might not anticipate a significant impact on daily functioning.

Original languageEnglish (US)
Pages (from-to)136-148
Number of pages13
JournalJournal of Pain
Volume14
Issue number2
DOIs
StatePublished - Feb 2013

Keywords

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

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Neurology
  • Clinical Neurology

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  • Cite this

    Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., & Donaghe, H. (2013). Low-dose vaporized cannabis significantly improves neuropathic pain. Journal of Pain, 14(2), 136-148. https://doi.org/10.1016/j.jpain.2012.10.009