Lena Yannella

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Tags:  Cannabinoid, CBD, chronic pain, opioids, cannabidiol, sleep, cannabis.

 

The problem:  Although opioids are a common treatment option for chronic pain, they often have negative side effects and increase the risk of addiction.

 

Why do this study?  Alternatives to opioids include cannabidiol (CBD) and tetrahydrocannabinol (THC), two molecules derived from the cannabis plant. CBD, which is legal and increasingly available as an over-the-counter product, has been shown to relieve chronic pain and reduce opioid use. However, the novel aspect of this study is its evaluation of CBD’s effect on opioid usage for pain relief within a single cohort.

 

The study:  The 97 participants who completed the study were stable opioid users, ages 35 to 60, suffering from moderate to severe chronic pain. After being educated on how to use CBD, the participants were given hemp-derived (15 mg), CBD-rich soft gels and the freedom to choose their daily dose. Of the ninety-four participants who opted to use the soft gels, 91 decided to use a dosage of 30 mg per day for the eight weeks. The side effects were minimal, but included individual reports of nausea, nighttime anxiety, and heart burn. After eight weeks, 53.2% of the CBD users stopped or at least reduced their use of opioids. Furthermore, 94% of CBD users reported improved quality of life, when responding to open-ended questions. The Pittsburgh Sleep Quality Index (PSQI) and the Pain Intensity and Interference (PEG) assessment revealed significant improvements in sleep and pain relief, respectively. However, the Pain disability index (PDI), 4-item patient health questionnaire (PHQ-4), and Readiness to Taper Visual Analog scale revealed no significant differences in pain-related quality of life and willingness to reduce opioid dose.

 

Conclusions:  Hemp-derived, CBD-rich extract oil may reduce opioid usage while improving quality of life with respect to pain and sleep.

 

What does this study add?  This study provides promising evidence for CBD as an alternative to opioids in treating chronic pain. 

 

Funder:  This study was funded by Ananda Professional. Ecofibre LTD both owns Ananda Professional and employs author Alex Capano.

 

Author conflicts:  None.

 

Commentary: (David Casarett MD) This study hitches its wagon to the growing interest in cannabinoids as potentially opioid-sparing. The results reported here are certainly impressive—more than half of these patients had a significant reduction in their opioid dose. Too good to be true? Probably. Presumably all of these patients wanted to reduce their opioid dose—why else would they enroll? So how much of this reduction was due to the CBD vs. their sheer commitment to reducing their opioid intake, plus a little placebo effect? This study didn’t have a control arm, so we don’t know. But I hope the next step is a placebo-controlled trial.