At the Canadian Pain Society’s conference last week, Dr. Jason Busse presented preliminary data on his study of cannabis as a pain reliever.
His research monitored 1,915 patients across 26 separate studies, the findings of which still need to be analyzed, but Busse admitted that revealing some of the initial data “was an attempt to provide preliminary findings, as part of a larger workshop on the role of medical cannabis in managing chronic pain.”
Clinicians used a scale of 1-10 to evaluate the amount of pain a patient experienced, a practice widely used in modern medicine. For about 12 percent of patients, cannabis reduced their pain by at least one point on the scale. Finding alternatives to prescription opioids is a priority among public health officials. The Canadian Institute for Health contributed $100,000 to the study.
“Current strategies are limited, and clinicians often resort to opioids,” said Dr. Busse. “(Medical cannabis) is something that we’re looking at for its potential to treat chronic pain. There is some evidence that it may be effective for some patients.”
Canada is the second largest consumer of opioids, with the United States coming in first. An project to track this public health crisis has recently gained momentum, thanks to work by individuals who have personally been affected by opioid addiction. Since British Columbia started providing naloxone free of charge to anyone who has a history of opioid abuse, it has saved lives but still functions as a stop-gap for those suffering from addiction. Health officials are struggling to find effective way to fight the crisis, and are willing to look at every possible solution.
“Now that there’s increasing pressure on patients and physicians to reduce the use of opioids for chronic pain, it’s interesting that there’s at least some preliminary information suggesting that medical cannabis may allow patients to do that,” said Busse. “Another area of interest is whether it can be used as add-on therapy to allow people to come down from some of the opioid medication.”
The research acknowledges the complexity of zeroing in on the precise compounds in cannabis that account for its pain-relieving benefits, which makes it difficult to work with in a clinical setting. “We can grow strains that have higher or lower levels of THC or CBD, (but) it’s difficult to say at this point the exact chemical composition that is the most effective in dealing with chronic pain while producing the lowest level of undesirable side effects,” said Busse.
In May, new guidelines for prescribing opioids were published by a team of 15 physicians, including Busse. The paper urges prescribing physicians to use opioids after other, less dangerous medications have proven to be ineffective. They also recommend smaller doses, “staying below 50 mg morphine-equivalent per day, which is quite a bit lower than the recommendation of 200 that came out in 2010,” said Busse. Particular attention has been paid to the use of Fentanyl, which the CPHA has indicated is “50 to 100 times more potent,” than morphine. It was intended specifically for patients who were terminally ill but doctors have been inappropriately prescribing it to patients for conditions like post-operative pain. The drug has been found in black market heroin, making the drug that much more powerful and addictive.