Neuropathic Pain Patients Find Relief in Cannabis-Based Treatments

Carsten Hjorthøj

Cannabis-based medicines (CBM) and medical cannabis (MC) were found to be safe and even displayed some positive effects among patients with neuropathic pain.

It’s been suggested that cannabis-based medicines or medical cannabis could potentially relieve painful symptoms for patients with neuropathic pain and other pain disorders. Previous evidence on this topic was deemed insufficient by investigators.

The prominent pharmacological treatment for many pain disorders is opioid treatment, which is known to be misused and cause severe side effects. Alternative treatment options are needed for this population.

The Study

In this study, a team of investigators led by Carsten Hjorthøj, Copenhagen Research Center for Mental Health--CORE, Mental Health Center Copenhagen, compared the effect of various types of cannabis-based medicines and medical cannabis on patients with neuropathic pain or other pain disorders.

Investigators used nationwide Danish registers like the National Prescription Registry to identify the population of people using cannabis-based medicines or medical cannabis for neuropathic or other pain disorders.

Included in the study were individuals who redeemed a prescription for cannabis-based medicines or medical cannabis for pain from January 2018-October 2019. This group was then divided by those with neuropathic pain and those with other or unspecified pain disorders.

Patients using cannabis-based medicines or medical cannabis were matched 1:1 using propensity score matching to a control redeeming a prescription for other medications with the same indication, excluding ibuprofen and paracetamol.

Due to many prescriptions only containing the word “pain” or similar in the field for indications, this category is referred to as other or unspecified pain disorders. This could mean that some patients with neuropathic pain may have been included in this category as well.

This study did not include patients with cancer-related pain because they were included in another study.

The Results

Investigators found that there may be benefits of cannabis-based medicines or medical cannabis use for patients with neuropathic pain. This could be especially helpful for patients with neuropathic pain who experience side effects of using gabapentin, as CBM/MC use has shown no indications of severe side effects.

A reduction in the use of gabapentin was observed with the use of cannabis-based medicines or medical cannabis among patients with neuropathic pain, potentially indicating a positive, pain-related effect among patients treated with gabapentin. The use of pregabalin was not equally reduced, however, so these findings should yield further research, and are ultimately inconclusive.

For the study, investigators identified 1817 individuals that redeemed at least one prescription for cannabis-based medicines or medical cannabis for neuropathic pain. Then, they were propensity score matched 1:1 to 1817 controls with neuropathic pain who did not redeem a prescription for cannabis-based medicines or medical cannabis.

The total number of individuals who redeemed a prescription for cannabis-based medicines or medical cannabis for other or unspecified pain disorders was 924 and were propensity score matched 1:1 to 924 individuals who never redeemed a cannabis related prescription for other or unspecified pain disorders.

Medical cannabis prescriptions were redeemed by 51.2% (930) of the cannabis-based medicines or medical cannabis users with neuropathic pain. Of the CBM/MC users with other or unspecified pain disorders, 23.9% (219) of individuals redeemed prescriptions for medical cannabis.

With much left to be discussed, the main conclusion remains that across the various spectrums, the population that benefited most from cannabis-based medicine or medical cannabis were the patients with neuropathic pain.

The study, “Cannabis-based medicines and medical cannabis for patients with neuropathic pain and other pain disorders” was published in The European Journal of Pain.